The Equity Collaborative Group

The Equity Collaborative Group (ECG).

(Image credit = Community View Collaboration through Hogg Foundation for Mental Health website)

We are a research lab focused on equity, quality, efficiency and advocacy in healthcare. In 2013, the Foundation of the Massachusetts Dental Society provided the first competitive grant to Dr. Romesh P. Nalliah which enabled the establishment of this research lab.

We believe that the publication of our research is the beginning of our work, not the end. We believe our research is not useful unless is translates into policy change, cultural change, or operational change. Our pursuit of equity has taken us down some very interesting paths over the years:

Special Care Dentistry. In Boston, when we learned about the difficulty pediatric dentists were having in finding general dentists to transfer their patients with special needs once they reached the age of 18. This began a journey of service and learning that resulted in a special care clinic integrated into Cambridge Health Alliance. We also received funding to make a video to train carers about how to take care of the oral health needs of the individual with special needs whom they care for. Dr. Nalliah's growing expertise in this field also resulted in him being selected as a State Dental Director for Special Olympics of Massachussetts. Fast forward to 2020, Dr. Nalliah's division (the Office of Patient Services) includes a brand new Special Care Clinic.

Synergy Program for Foreign Trained Dentists. Dr. Nalliah trained at the University of Adelaide in South Australia. When he moved to the United States he spent a year teaching dental assistants in downtown Chicago while he pusured licensure in the United States - this was a very difficult year for him. "I was blessed to get an opportunity to research, teach and practice at the Harvard School of Dental Medicine" recounted Dr. Nalliah. Meeting many foreign trained dentists in Boston, Dr. Nalliah became frustrated with the number of highly talented individuals who were working as dental assistants and underemployed in a variety of ways. At ECG, we decided to build a continuing education course to support foreign trained dentists who were trying to enter advanced standing dental education programs in the United States - the Synergy Program. Synergy has been highly successful in accomplishing it's goals. Moreover, many foreign trained dentists have served in ECG. Synergy also provides consulting services on CV's and personals statements. Click here.

Opioid overprescribing. Over dinner with his pharmacist friend, Dr. Nalliah learned that dentists overprescribe antibiotics. The two friends published an article documenting the metrics of this phenomenon. Later, the brilliant Eileen Kostanecki brought to Nalliah's attention the potential problem of overprescribing of opioids. This has resulted in millions of dollars in grant support, numerous publications and resulted in Nalliah and Michigan OPEN leading the writing of the dental opioid prescribing guidelines for Michigan.

Homeless oral health. Dr. Nalliah's church in Boston began delivering food and socks (foot health is a major problem among the homeless) to homeless individuals. We decided to implement oral health screenings which spawned a health delivery program (including physicians, podiatrists and nurses). To go a step further than screenings, ECG was able to leverage community partnerships to access a disused dental clinic in downtown Boston and form a free clinic for homeless individuals! Not only have many individuals who are homeless received care, but numerous dental students and dental public health residents at Harvard School of Dental Medicine have also received unique training in this clinic.

Oral-Systemic Health. Repeatedly, we have encountered the chronic undervaluing of oral health and a misunderstanding that oral health is separate from the rest of your health. Dr. Nalliah has published several articles on oral-systemic health associations. More importantly perhaps, Dr. Nalliah has trained numerous physicians at Boston Medical Center, Beth Israel Deaconess, Harvard School of Public Health, and Mass General Hospital about oral health. Also, he has lectured extensively about oral-systemic health.

Big data science. Studying trends in public health and a fascination with population health has repeatedly brought ECG to big data science. ECG has over 60 publications in big data science and numerous lectures around the country and world. ECG's work in big data research has uncovered trends that were previously not known or well understood. In collaboration with Michigan OPEN, Nalliah and his lab have uncovered a variety of trends associated with opioid prescribing - this knowledge is extremely valuable in understanding overprescribing and reversing it. ECG's own work has identified the existence of a persistent gap in oral health outcomes between Black Americans and other Americans. Finally, in various collaborations (Dr. Sath Allareddy and Institute for Healthcare Policy and Innovation to name two) ECG has leveraged big datasets to study connections between oral and systemic health.

Free Care.
All of our research has uncovered numerous groups of underserved populations. Our vision is that our work will impact communities and not just scientific communities who read our manuscripts. Therefore, our lab has rolled up our sleeves and delivered free dental services to thousands of people. To date, we have delivered over $220,000 of free care and dental products. This includes establishing two free clinics (as mentioned above - one for individuals who are homeless and one for individuals with special needs), close to 100 oral health screening events that aimed to integrate patients from underserved populations into a permanent dental home.

Inter-professional Collaborative Care.
We were invited into Mass General Hospital (Chelsea, MA), as consultants, to help resolve their major dental access problem. This resulted in a wonderful inter-professional collaboration that included dental training of the medical team and the integration of an oral health screening into the general medical physical exam. Overall, these chronically ill patients received care from dental, medical, pharmacy, and nursing and social work students. Dr. Nalliah received external funding from three sources and this was integrated as an elective into the Harvard DMD curriculum for 2015-16. Moreover, MGH acquired funding to purchase a dental van that was kept parking area and cleverly solved their space problem.

Our mission at The Equity Collaborative Group is...

"to train and inspire leaders who will change the world they live in."