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Healthy Nevada Project: Improving health through genetics and big data

Study gauges Nevadans’ health risks

To understand the factors that impact the health of the individuals we serve within our community, we have to look outside the walls of the hospital.

At Renown Health in Reno, Nev., we recognize that to significantly impact the health of our community, we have to learn more about the exact relationship between health, genetics, social determinants of health and the environment.

I am tremendously proud of Renown Health’s collaboration with the Desert Research Institute, a world leader in environmental sciences and the application of scientific research and new technologies. Together, we are conducting a ground-breaking, community-based population health study that holds great promise.

With the Healthy Nevada Project, we are combining genetic data with health and population data, as well as information from environmental databases, to identify and model public health risks ranging from disease and illness to the effects of environmental factors such as air quality on the health of Nevadans. This information will help us respond strategically to the future health needs of our patients and communities, thereby improving care delivery in our region.

The purpose of this pilot study was to understand the population health needs of the northern Nevada community by assessing environmental data, population health outcomes, genetic information and socio-economic determinants. The goal is to improve health outcomes by not only treating disease, but preventing disease by finding connections in the data.

This transformative approach to population health started over a simple cup of coffee with a fellow New Jersey native, Joe Grzymski, PhD, a senior director at the Desert Research Institute. I expected we would chat about our home state, but our conversation quickly turned to ways we could collaborate. We began to brainstorm ways we could combine Renown Health’s clinical data with DRI’s environmental data to better understand the ways outside factors affect health outcomes in our community.

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The data we are gathering may help predict who may be at risk, allow for quicker diagnoses, reduce costs and improve health care by changing participant behavior. A unique team of machine learning experts and data scientists at DRI are utilizing the latest advanced analytics techniques to gain greater insights into the data. Funding was provided by the Renown Health Foundation and Nevada’s Knowledge Fund.

The initial study launched Sept. 15, 2016 to 5,000 potential participants and offered community members the opportunity to volunteer for research and gain access to their individual genetic information at no cost. The list filled in less than 24 hours, so we doubled the study size (which filled in another 24 hours).

Participants in the Healthy Nevada study range from ages 18-90 years old and from 135 zip codes in northern Nevada. Socio-economic survey information was obtained using an advanced online survey tool, and all responses remained confidential.

The information is sorely needed. A recent community health needs assessment conducted by the Washoe County Health District and Renown Health determined the top three causes of death in Washoe County, Nev., are heart disease, cancer and chronic lower respiratory disease. This trend holds true for Nevada and the United States. Washoe County rates, however, are higher, and the economic impact of these diseases is significant — communities and families must shoulder the burden of increases in medical costs, reduced productivity and lower quality of life.

It is our hope that the aggregate data obtained through the Healthy Nevada Project, combined with personal health data information delivered to study participants and health education and outreach interventions, may contribute to a reduction in heart, respiratory and cancer casualties and provide our community with a higher overall quality of life.

We’ve also begun adding cohorts to the study. The first includes a group of extraordinary athletes from the High Fives Foundation, a Truckee, Calif.-based nonprofit that provides resources and inspiration to mountain athletes who have suffered life-altering injuries. Through this new cohort, we hope to unlock some of the keys to better treatment and success in survivorship for those who experience devastating injuries.

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Looking forward, we hope to build an infrastructure to apply the population health pilot to all 2.9 million Nevada residents to enable researchers to build predictive models to look for significant population health factors that consider demographic variables—gender, age, income, location—as well as factors that determine community health, individual health and likelihood of chronic disease.

As a healthcare system with the largest market share in our community, this is the ultimate in strategic planning. If our community is more at risk for cardiovascular disease 10 years from now, we can be thoughtful about recruiting cardiologists. If we know that the population is growing in pediatrics, we can start a program for pediatric residents at the University of Nevada, Reno School of Medicine and grow our pool of pediatricians. The horizon for planning can be kept in view because we’re learning about our population’s health and disease. And that’s just good medicine.

Tony Slonim, MD, DrPH, is President and Chief Executive Officer of Renown Health in Reno, Nev. He is a proud father, physician leader, mentor, TEDx speaker and cancer survivor. Follow Dr. Slonim on Twitter and on his CEO Blog

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