HSDM Student Group Receives Major Grant

An HSDM student group was one of four inaugural winners of a major Abundance Agents of Change Challenge Grant from the HMS Center for Primary Care. The project, “Integrating Oral Health into Diabetes Group Visit Models: An Interdisciplinary Approach to Primary Care,” involves four HSDM students and one HMS student working in collaboration with the Windsor Street Health Center in Cambridge, Mass. Participating students are Raina Chandiramani (DMD 2016), George Chen (DMD 2016), Seana Hedayatnia (DMD 2016), Viet Nguyen (MD 2016), and Helen Yang (DMD 2016).

The Challenge Grants charge Harvard students to create projects that promote innovation in health care delivery. The innovations must be designed for populations in the Greater Boston Area who are served by community health centers. The program is designed to connect HMS students, community health clinics, physicians-in-training from Harvard’s academic medical centers, and members of the Harvard University graduate schools.

Below is a brief description of the project.

Creating a New Model

Diabetes, which affects more than 26 million adults, is poised to become one of the most significant contributors to disease burden and health care costs in the United States. The American Diabetes Association estimated that one out of every three children born after 2000 in the United States will be directly affected by diabetes and that approximately one in ten health care dollar expenditures are now attributable to diabetes.

While it is well known that diabetes harms the kidneys, heart, eyes, and nerves, periodontitis—inflammation and infection of the gums and alveolar bone that causes pain, bleeding, and tooth loss—is often overlooked as a complication of diabetes. Emerging research has shown that diabetes and periodontitis are interrelated: diabetics have a higher risk of developing severe gum disease, while periodontitis is associated with poorer blood sugar control and disease progression.

As the prevalence of chronic diseases, expenses, and disparities in access to care increases, providers are seeking new health care delivery models to address these issues. Promising models, such as the Patient-Centered Medical Home and Group Visits, emphasize comprehensive and integrated care. Historically, dentists have not been part of the primary care team, but mounting evidence on the oral-systemic connection of many chronic diseases suggests that it is time to adopt novel ways of increasing collaboration between physicians and dentists.

Under the grant, the student group plans to create a new model, in which a dental team (consisting of a dentist, hygienist, and translator when needed) is incorporated in the existing diabetes group visits at the Windsor Street Health Center (WSHC) and trained to provide screenings, basic oral care, and oral health education in a group setting. In addition to oral health, the group will focus on holistic chronic care management, by training the health care team to address issues of mental health, nutrition, and overall wellness. By providing patients a community of peers, with similar goals, backgrounds, and experiences, the group seeks to increase health literacy and support lifestyle changes. This model has the potential to be cost effective, efficient, and transferable across health centers. Ultimately, the group plans to showcase this model as an example of the value of interdisciplinary communication and collaboration between dentists and physicians.