The VCU Schools of Nursing and Dentistry have partnered with Virginia Premier Health Plan, Inc. to establish an innovative model of health care that is expected to enhance dental and physical health outcomes among vulnerable populations.

In a pilot program that integrates dental and physical health services, the schools have established a nurse practitioner-managed health center to identify and address significant health issues among patients who are receiving dental care at the VCU School of Dentistry.  The center, named the VCU Neighborhood Partners Practice, is the first of its kind at a university in Virginia.  This practice focuses primarily on Virginia Premier Health Plan, Inc. participants.

Using oral visits as the entry point, a nurse practitioner in collaboration with a physician will conduct comprehensive health exams at the center, as well as offer health promotion education. The goal is to refer patients back to their primary care physician (PCP) to address chronic health conditions, such as diabetes, high blood pressure, cardiovascular disease, cancer and respiratory illness.  For patients who do not engage with their PCP, center staff will help connect them to their health plan’s case managers and/or physician network to assist in building the relationship.

“We are pleased that Virginia Premier is a part of the Schools of Nursing and Dentistry’s efforts to provide health promotion and disease prevention services for Richmond’s most vulnerable and underserved populations,” said Nancy Langston, Ph.D., RN, FAAN, ANEF, dean and professor, VCU School of Nursing.  “This interdisciplinary approach to health care is the latest example of VCU’s commitment to becoming a national model of community engagement.  We’re setting a benchmark for developing innovative, patient-centered programs to address health care disparities of the 21st century.”

Studies have supported a possible relationship between periodontal disease and various medical conditions, such as coronary artery disease, stroke, pre-term births, and low birth rate, according to Debra Lyon, Ph.D., RN, FNP-BC, FAAN, the Judith B. Collins and Joseph M. Teefey Distinguished Professor and chair of VCU’s Department of Family and Community Health Nursing.

“These health conditions appear to become more exacerbated due to poor dental hygiene and periodontal diseases,” said Lyon, who is leading the pilot program. “Through integrating dental and health care services to co-manage patients, we intend to promote improved dental and health outcomes.”

The model is also expected to ultimately reduce overall health care costs, Lyon said. “Many people often wait until their dental problem or other health condition is severe and seek emergency treatment at a hospital,” she said.  “Our model encourages use of primary care at the patient’s medical home – the family physician or nurse practitioner.”

Approximately 16,000 Virginia Premier members are currently active in the VCU’s School of Dentistry’s Practices, which serve more than 35,000 patients each year.  The new health center is expected to initially draw about 5,000 visits annually.

The NP-managed center will be similar to a partnership model in place at New York University’s Schools of Nursing and Dentistry, where a health clinic provides comprehensive physical examinations and primary care as a result of oral visits.  Outcomes in hypertensive and diabetic patients have already shown overall improvement since the program was implemented in 2006.

“The dental practice model is based on risk assessment and prevention of oral diseases with an emphasis on patient education,” said David C. Sarrett, D.M.D., M.S., dean of the VCU School of Dentistry. “We believe that using visits to the dentist as an on-ramp to identify and manage other diseases makes a lot of sense.  We are very excited and pleased to be part of this program and greatly appreciate the support of Virginia Premier.  Dean Langston and I have been talking about the value of such a program for several years and now it will be a reality.”

The VCU Neighborhood Partners Practice will be located in the Wood Memorial Building of the School of Dentistry building complex, where two exam rooms have been renovated and outfitted with new equipment. Judith Parker-Falzoi, M.S., B.S.N., B.S, FNP-BC, a family nurse practitioner and assistant professor at the School of Nursing, will be the clinical director of the center. The collaborating physician is Dr. Steven Crossman of VCU’s Department of Family Medicine.

Future plans may include offering services to participants of other health plans.  The center is also being considered as a possible training site for students and for research collaborations between VCU health and social sciences programs, according to Lyon. “This is just the first phase of this project, so we’re excited about the opportunities to design and sustain this practice to make it a transformative health resource for the community and all involved,” Lyon said.

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