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Harvard and Northeastern launch new care model

Detailed model guide, webinar available

May 21, 2018

By Michelle Manchir

Photo of dental students with patient
Collaborative care: Monica Tain, a fourth-year dental student at Harvard School of Dental Medicine, Paul Chung, a first-year dental student at Harvard, and Meghan Harrington, a second-year nurse practitioner student at Northeastern University, visit with a patient at Harvard dental school's clinic. The students are part of the Nurse Practitioner & Dentist Model for Primary Care, developed by Harvard and Northeastern. Photo by Steve Gilbert
Boston — Depending on their needs, patients who visit the Harvard School of Dental Medicine clinic for dental care may also see a nurse practitioner to discuss and map out a comprehensive treatment plan.

The collaborative care represents a model the school developed with Northeastern University School of Nursing. The two institutions in 2015 were awarded a cooperative agreement from the U.S. Health Resources and Services Administration to create and test a novel practice environment where nurse practitioners, dentists and students from both disciplines work together to provide patient care.

In April, the groups released a guide outlining creation and implementation of the Nurse Practitioner & Dentist Model for Primary Care, dubbed the NPD model, for no cost online to encourage other educational institutions and even private practices to implement it. The guide is available at harvard.edu.

A May 1 webinar was also recorded, outlining the major steps implementing the model, and is also available online at no cost at pathlms.com. The webinar requires an American Dental Education Association account, which can be created at the link for free.

The clinic within Harvard was an ideal location for the model's pilot, as it sits on a campus surrounded by urban neighborhoods populated by people with high rates of cardiovascular disease, diabetes and cancer, according to the guide. The target population for the model was older adults (aged 65 years or older) living with one or more chronic health conditions.

Before the program launched, many dental patients at the Harvard clinic did not have any sort of primary care provider whom they saw regularly, said Maria Dolce, Ph.D., who is also a registered nurse, associate professor of nursing at Stony Brook School of Nursing and was principal investigator for the project. The model offered many of them the opportunity for more thorough care.

"Overwhelmingly, patients love seeing the nurse practitioner during the dental visit. It's a very holistic approach to care," she said.

Dr. Bruce Donoff, dean of the Harvard School of Dental Medicine and also a member of the ADA Council on Dental Education and Licensure, said he sees the model as a potential solution to the primary care provider shortage some populations face.

Additionally, it benefits students who get hands-on interprofessional experience, he said. Both nurse practitioner and dental students at Harvard are required to complete rotations in the clinic as part of the model.

"There's a lot of attention paid right now to interprofessional education," said Dr. Donoff, who said he has already heard from deans of other U.S. dental schools interested in the NPD approach. "This model really puts teamwork into action and gets professionals working together to improve the patients' care."

Dr. Dolce said she believes the model can be used to serve patient populations other than older adults, and that private practice clinicians — not just dental educators — should consider it.

The guide addresses the sustainability of the program, including keeping it financially sound and acquiring payment. While it varies by state, most nurse practitioners can bill the services they provide and receive reimbursement that comes back to the dental practice, Dr. Dolce said.

For those with questions about the NPD model, Dr. Dolce recommends first listening to the webinar and reading through the guide to gather the basic details of it. She also welcomes questions by email at maria.dolce@stonybrook.edu.