Clinical Practice

  • Nurse taking blood pressure

    Clinical Models that Integrate Medical and Dental Care

We pilot new models to develop best practices for clinics of the future.

 

NURSE PRACTITIONER-DENTIST MODEL (NPD)
Innovative model where a Nurse Practioner works in the dental clinic.

Piloted since 2015 at the Harvard School of Dental Medicine’s Teaching Clinic, the NPD model is a collaboration with Northeastern University made possible with funding from HRSA. The model promotes interprofessional practice and education by integrating primary care services provided by a nurse practitioner into an academic dental practice environment.

Nursing and dental students work in teams and are jointly responsible for providing primary care and dental services to patients, who may be screened for hypertension and diabetes in their dental visit.

During supervised clinical rotations, dental and medical students learn how each profession formulates diagnoses, implements preventive interventions, and makes referrals within their scopes of practice. Students develop interprofessional plans of care under the direct supervision of NP and dental faculty. Since February 2016 dozens of NP students from Northeaster University have rotated through the dental clinic and have enhanced their oral health skills.

Project team releases guide and webinar to promote adoption of model

NPD Collaborative Care Guide bookTo encourage educational institutions and private practices to adopt the NPD model, the team released a guide and webinar that provide a framework for planning, implementing, and evaluating the NPD collaborative care model. The guide includes templates for developing timelines, estimating resource requirements, determining quality measures, designing curriculum, and planning operational workflows.

The guide and webinar are available online at no cost:
A Guide for Implementing Collaborative Care in U.S. Dental Schools (PDF)
Webinar (requires an ADA account that can be created for free)

News articles:
Harvard and Northeastern launch new care model. Detailed model guide, webinar available.
Harvard, Northeastern project bring dental, primary care together
Fluoride and a physical: Patients see docs at the dentist
 

 

EQUITABLE CARE FOR THE ELDERLY (ECE)
Training programs, developed at HSDM, that support health centers around the nation in addressing gaps in care among seniors.

The National Center for Equitable Care for Elders aims to improve health care access and outcomes for vulnerable senior populations by providing training for heath care providers who serve the elderly, particularly in underserved areas. Examples include webinars that teach strategies for delivering care to patients with dementia, disabilities, depression or a chronic health condition.

The need is enormous—in 2010 there were 40.3 million people aged 65 and above (13% of overall population). By 2050 the percentage is projected to grow to 20.9. At the same time, the number of physicians with advanced geriatrics training is declining and many are opting out of Medicare.

The ECE project is funded by a $1.5M grant from the National Cooperative Assistance Agreement (NCA) that was awarded to HSDM’s Christine Riedy and an interdisciplinary team from Beth Israel Deaconess Medical Center, Simmons College of Social Work, SUNY Nursing, HMS Primary Care and Harvard TH Chan School.

 

COLLABORATORS IN PRACTICE
Partnerships with health systems and communities to better integrate oral health with primary care services.

Two of our partners, CareMore—an eight state Medicare advantage plan, and Commonwealth Care Alliance (CCA)—a Massachusetts based care and benefits provider, focus on providing care to Medicare and Medicaid populations that traditionally have had challenges accessing oral health care services.

We are working with both organizatins to develop best practices for the integration of dental services for medically complex patients. Together we are learning how to most effectively deliver oral health care to these vulnerable populations and we are studying the associated health and cost outcomes.