Reaching Out to Families in Need

Epic helps Harriet Lane Clinic doctors reach patients whose pharmacies were destroyed by looting.

Published in Dome - July/August 2015

The images are broadcast around the world: thick gray smoke pouring out of a Baltimore CVS. Windows smashed. Mer­chandise stolen. A woman smells fire in the night air as her local drugstore burns.

Days later, her phone rings. It’s Jessica Berger, medical resident at the Harriet Lane Clinic of The Johns Hopkins Hospital, of­fering to move her children’s prescriptions to a different pharmacy. As they talk about the family’s health, the woman requests a refill of albuterol, the medication her son relies on to calm his asthma.

Berger looks at the child’s medical record, open on her computer screen, and sees that the prescription was filled re­cently. She asks if the child is having asthma attacks, and the mother says he is. Berger helps her set up an appointment for her son, writes a prescription for albuterol and sends it electronically to the new pharmacy.

The woman was among those telephoned by Harriet Lane clinicians after the April 27 riots in Baltimore. Members of the Har­riet Lane team suggested the outreach dur­ing staff meetings in the days following the violence. Megan Tschudy, assistant medical director for the Harriet Lane Clinic, recog­nized that Epic, the electronic medical re­cord system, could be used to identify fami­lies with prescriptions at looted pharmacies.

Project administrator Gian Bonetti tapped Epic to generate a list of all 157 Harriet Lane families with active prescriptions at shuttered pharmacies. The task took less than half an hour, he says, adding that it would have been prohibitively time-consuming under the paper record-keeping system in place before Harriet Lane switched to Epic in 2013.

Clinicians reached 102 families on the list and left messages when possible for the rest. Doctors switched pharmacies for 71 patients, asked how residents were coping with the unrest, referred people to city services, and scheduled well visits and asthma treatment appointments.

“Every family we spoke with was extremely thankful for our outreach efforts,” says Tschudy.

“We were being proactive instead of wait­ing for patients to call us,” says Berger. “Ev­erybody was appreciative. I was touched by the response.”

The protests and violence in Baltimore have drawn attention to the challenges faced by many of the city’s poorest residents, a population served by the Harriet Lane Clin­ic. Of the 7,500-plus children and adoles­cents seen by the clinic each year, 94 percent are on public insurance, says Tschudy.

Founded in 1912, the clinic serves as a com­plete medical home, with services that include after-school tutoring and mental health treatment. Through a program called Health Leads, staffed by Johns Hopkins University undergradu­ates, patients are con­nected to such resources as food pantries, job training and low-cost child care.

The pharmacy outreach wasn’t the first time Epic helped Harriet Lane clinicians identify and help a specific category of patients. In March, with Bonetti’s help, Tschudy created a list of 200 children and teens who suffer from both allergies and asthma. Maria Miles, a clinic community health worker, contacted the families before allergy season began, reminding patients to take their asthma medications regularly, ask­ing if refills were needed and sharing other strategies for coping with poor air quality.

“This is what preventive medicine is about,” says Tschudy.