POPULATION HEALTH
Health Breakthroughs Driven by DNA Analysis in Nevada
Heather Allen’s health was deteriorating by the day. A young mother and high school math teacher, Allen was experiencing inexplicable symptoms, including fatigue and hard-to-fight infections. Doctors searched for answers, but nothing seemed to work, leaving them perplexed by her condition.
Then one night everything changed.
The previous year, Allen was one of 10,000 Nevadans to sign up for a genetics initiative called the Healthy Nevada Project. A recent breakthrough allowed for further DNA testing and soon after, her results arrived. Allen learned she had a high propensity for Alpha-1, a genetic condition that causes lung and liver disease. Tests confirmed the DNA results and an official diagnosis, and soon the mother was on a path to monthly treatment.
“If not for the Healthy Nevada Project, I believe I’d be dead,” Allen said.
Reversing Poor Health Outcomes with Analytics
Developed by Renown Health and its innovation institute, the project is one of the first community-based population health studies in the United States. By combining genetic and environmental data with individual health information, researchers and physicians are gaining new insights, enabling personalized care while improving the well-being of entire communities in Nevada.
The project comes at a time when the state continues to struggle with poor health outcomes and excess costs. Nevada ranks near the bottom of overall wellness rankings in the U.S. and suffers from high mortality rates for chronic conditions such as heart disease and cancer.
“This was our call to action,” said Dr. Anthony Slonim, president and CEO of Renown Health, which operates four hospitals in Reno.
To address Nevada’s most complex population health problems, investigators started by collecting data. Working in tandem with environmental experts at the Desert Research Institute, Renown Health fuels the project with clinical data, and supplements it with information from the Environmental Protection Agency and others.
Data scientists applied machine learning and artificial intelligence capabilities to the DNA results to see exactly how all of these factors affect health. This formed connections between participants’ genetic information and varying environmental factors, such as air and water quality, calculating who might be predisposed to certain conditions. This could allow analysts, for example, to identify people prone to breathing problems and notify them to stay indoors when air quality is poor.
“We’re working to understand how environmental factors can help predict who may be at risk, allow for quicker diagnoses and encourage the development of more precise treatments,” said Jim Metcalf, the Healthy Nevada Project’s chief data scientist. “The modern statistical and machine learning methods have been critical elements of our success to date.”
An Ounce of Prevention
The Healthy Nevada Project benefits citizens and researchers alike.
For citizens, it’s one of the first broad genetics studies in the nation to return clinical results. Consenting study volunteers are learning of their risks for many serious genomic conditions including familial hypercholesterolemia and Lynch syndrome, which is tied to endometrial and colon cancers.
For researchers, the project offers a unique opportunity to study pathogenic mutations and alert the people who have them. Recently, project staff identified 115 individuals with hereditary high cholesterol that’s related to increased risk of heart disease and not always diagnosed with typical testing. With this information, administrators can contact subjects and suggest they speak to a doctor.
“If we understand why people are at risk for certain diseases because of their DNA, we actually might be able to do something about it,” Slonim said. “We can give them the information, help them change their behavior and understand how to address those preconceived risk factors.”
Insights from Healthy Nevada also helped Slonim with resource allocation. By knowing that a significant percentage of the population has a certain condition, he can implement prevention programs and hire doctors with the skills to treat those patients in five to 10 years.
“This is the ultimate strategic planning process for our community,” Slonim said. “If we can uncover things that put people’s health at risk, our health care providers can do appropriate screening and, ultimately, take better care of our people.”
Aspirations for a Healthier America
Slonim aspires to make Nevada the country’s healthiest state, and one day power a Healthy USA Project. More than 50,000 Nevadans have already donated their DNA, and the project has now expanded into Southern Nevada and Las Vegas, with hopes of spreading to other health systems around the country.
“If we bring on just one major health system per state, this could really advance the work needed from a national perspective to get a grip on chronic disease,” Slonim said.
The health system president and CEO welcomes those seeking advice on similar initiatives. The mission is personal for Slonim, a cancer survivor who credits early intervention for saving his life.
“I’m a believer in this and this is what personally, for me, drives the project,” he said. “I believe we can make large communities, large states and perhaps even America healthier if we use these tools for the benefit of good.”
This article features interviews with:
Dr. Anthony Slonim
President and CEO
Renown Health
Reno, Nevada
Jim Metcalf
Chief Data Scientist
Desert Research Institute
Reno, Nevada
