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As the Healthy Nevada Project expands to 50,000 study participants, researchers are sharing the health insights gleaned from the pilot phase of the project.   Air pollution is a major health factor affecting northern Nevadans, according to data gathered by researchers in the pilot phase of the Healthy Nevada Project, one of the largest population health studies in the country. Today, the project — which began 18 months ago as a partnership between Renown Health and the Desert Research Institute — is expanding to add 40,000 additional participants bringing total enrollment to 50,000 Nevadans. “We are thrilled to share the first insights from our 10,000-person pilot phase and discuss how we will begin using those results to improve patient care,” says Anthony Slonim, M.D., Dr.PH., FACHE, president and CEO of Renown Health and president of Renown Institute for Health Innovation, a collaboration between Renown and DRI. Healthy Nevada Project Pilot Phase — and What Happens Next The pilot phase of the Healthy Nevada Project proved Nevadans are excited to know more about themselves and want to contribute to research that could improve health outcomes for the entire state. The pilot phase enrolled 10,000 participants in less than 48 hours and DNA sample collection from each participant was completed in just 69 working days. Based on pilot phase data, researchers have seen increased use of regional healthcare services correlated with fluctuations in air quality and so-called “bad air events” such as wildfires and atmospheric inversions. In phase two, Renown IHI will evaluate possible links between genetics and increased susceptibility to respiratory ailments. Study researchers also announced care providers and scientists will begin working on a number of clinical programs and scientific studies focused specifically on Washoe County’s high age-adjusted death rates for heart disease, cancer and chronic lower respiratory disease. Collectively, these conditions among local residents stand at 33 percent above the national rate. In the coming months, Renown IHI will begin providing advanced calcium score screenings to pilot phase participants at higher risk for cardiovascular disease. This will allow researchers to examine the link between genetics and calcium buildup in the heart. Researchers are also evaluating future studies focused on age-related macular degeneration and breast cancer risks in northern Nevada.   Pilot Phase Insights Fifty percent of pilot study participants responded to a comprehensive, socioeconomic survey, which revealed: High rates of lower respiratory disease in northern Nevada and co-morbidities such as diabetes and hypertension suggest air pollution in northern Nevada is a confounding and significant factor in health. Study participants had parents who died from cancer and heart disease at a higher rate than the age-adjusted national average. Study participants exercised less than recommended by the American Heart Association and expressed interest in receiving help with behavior modification using diet/nutrition and weight loss tools. In phase two, if study participants choose to complete a follow-up survey, they will have the chance to pick an additional health and wellness app specific to their individual genetic results. Learn More To see if you are eligible to participate in the study, to sign up for study updates and for full details on the Healthy Nevada Project, please visit HealthyNV.org.

Read More About Healthy Nevada Project: What We've Learned

The Healthy Nevada Project – a first-of-its-kind population health study combining genetic, clinical, social and environmental data – has reached another landmark milestone. The study is notifying study participants at risk for familial hypercholesterolemia, BRCA and Lynch syndrome. “I took part in the Healthy Nevada Project to find out my ancestry. I didn’t even realize the test could give me so much information,” says 29-year-old Jordan Stiteler, who was recently diagnosed with familial hypercholesterolemia (also known as FH) through the Healthy Nevada Project. “After my dad passed away suddenly at age 45, I learned I had high cholesterol but I didn’t know it was genetic and I didn’t get an FH diagnosis until last week,” Jordan explains. “I immediately changed my diet, started walking more and doing more cardio. I also set up an appointment with my primary care physician for the first time in a while. I’ve talked with my family and even strangers about testing since my diagnosis. I hope my story will inspire others to test and can save someone’s family from going through the same loss I did.” Healthy Nevada Project Notifying Patients of Familial Hypercholesterolemia Risks Jordan is among the first Healthy Nevada Project participants to receive clinical results from the genetic study led by Renown Institute for Health Innovation (Renown IHI) – a collaboration between Renown and the Desert Research Institute Foundation. This groundbreaking population health study is now reaching out to study participants like Jordan, who asked to be notified of health risks. If study volunteers choose, the project will also provide guidance on treatment and additional testing for family members who may also be at risk. The project is starting with the return of FH risks which is a genetic tie to high cholesterol. Just a few months ago, a paper in the Journal of the American College of Cardiology recommended genetic testing become the standard of care for patients with a definite or probable FH diagnosis. Jordan says she plans to have her young son tested as well. “This is the future of health; not just reacting to sick people, but a coordinated effort between innovative technologies, data-driven researchers, and responsive practitioners to deliver personalized interventions to identify, prevent and treat disease,” says Anthony Slonim, M.D., Dr.PH., FACHE, president and CEO of Renown Health and president of Renown IHI. “As care providers, we often don’t see patients until they’re already sick and that’s a difficult problem. By embracing personal genomics, we can accelerate the ability of researchers to access data and apply those learnings back to our health system sooner.” In the Months Ahead: Notification of BRCA1/2 & Lynch Syndrome Risks The Healthy Nevada Project will start notifying study volunteers at risk for other CDC Tier 1 conditions including hereditary breast and ovarian cancer syndrome (BRCA 1/2 genes) and Lynch syndrome in the months ahead. These conditions are the key focus for the Healthy Nevada Project. The reason: Because early detection and treatment will save lives, and these conditions are some of the most common. “This research allows us to look into cancer, cardiac, respiratory illness and beyond to identify underlying causes, assess real risks and eventually initiate appropriate preventive actions much earlier. Human subject research is often intangible to participants – we are treated as subjects. The Healthy Nevada Project is creating actionable information for our participants while engaging in leading-edge research on health determinants,” said Joseph Grzymski, Ph.D., associate research professor at DRI, principal investigator of the Healthy Nevada Project and chief scientific officer for Renown Health. Landmark Population Health Study Continues to Expand Since launching two years ago, the Healthy Nevada Project has quickly evolved and expanded. The pilot project enrolled 10,000 participants in just 48 hours in September 2016. In March 2018, phase two of project expanded to an additional 40,000 participants with genetic testing partner, Helix. Helix’s genomic sequencing provides participants and researchers greater depth and quality of DNA data. With this, they can gain further insights to improve health. During a recent media roundtable announcing the return of clinical results, the Healthy Nevada Project also announced plans to complete testing of 40,000 people by the end of 2018. This will bring the project’s total enrollment to 50,000 people – approximately 10 percent of northern Nevada’s population. The Healthy Nevada Project hopes to reach more than 250,000 people in its next phase. The ultimate goal is to offer genetic testing to every Nevadan interested in learning more about their genetics and health. Join the Healthy Nevada Project Recruitment for phase two is still open. In addition to opting in to receive clinical results, participants receive National Geographic’s Geno 2.0 ancestry app at no cost. They also have the chance to pick an additional app for health and wellness after completing a follow-up survey. Learn More or Sign Up

Read More About Healthy Nevada Project Returning Clinical Results to Participants

Your mother had breast cancer. Your uncle had colon cancer. A cousin has stomach cancer. Could yours be the next name to make the family cancer list? “Possibly,” says Dr. Robert Nathan Slotnick, MD, PhD, Medical Geneticist at Renown Medical Group. In this article, the doctor discusses the genetics behind Lynch syndrome — and how you and your family can fight it. What is Lynch Syndrome? Lynch syndrome, also known as hereditary non-polyposis colorectal cancer (HNPCC), is one of the most common genetic conditions known to increase cancer risk in individuals and families. It enables colon and other cancers to develop by causing mutations in mismatch repair (MMR) genes. “The genes MLH1, MSH2, MSH6, PMS2 and EPCAM normally help to repair damaged DNA,” explains Dr. Slotnick. “But when they don’t work properly, naturally occurring DNA replication errors are not repaired efficiently. These errors accumulate and cancer can be the result.” Colon cancer is just one of many possibilities. People with Lynch syndrome also have a higher risk of developing endometrial cancer (cancer of the inside lining of the uterus) as well as cancer of the ovaries, stomach, pancreas, kidney, brain, and bile duct, among others. These syndrome-enabled cancers often appear in patients before the age of 50. Family Cancer Clues The family connection to cancer is a strong one notes the doctor. “Cancer is best considered a genetic disease because it is always tied to changes (or mutations) in our inherited material: our DNA,” says Dr. Slotnick. “These DNA changes cause cells to lose control of their normal constraints on growth and metabolism and can allow abnormalities to develop.” “Although all cancers are genetic,” he adds, “not all cancers are hereditary or passed down through generations.” But because Lynch syndrome IS a hereditary condition, personal and family cancer histories provide invaluable information toward diagnostic confirmation and to a path of surveillance, prevention and treatment. Once a strong family history of cancer is confirmed, doctors and geneticists can move forward with targeted genetic testing to identify specific gene mutations. If Lynch syndrome is diagnosed, testing can also reveal your risk for associated cancers. And your results could be a wake-up call to family members. According to the Centers for Disease Control and Prevention (CDC), close relatives of people with Lynch syndrome have a 50% chance of having similar gene mutations and a higher risk of cancer. The good news is detection and prevention progress is being made. “Lynch is just one of many cancer syndromes where risk is tied to heredity,” explains Dr. Slotnick. “In the last few years, our ability to identify those at risk for this type of cancer predisposition has improved markedly, both in diagnostic accuracy and cost. This allows us to provide aggressive surveillance and prevention choices to individuals and families at risk. Healthier families and lower cost: it’s a win-win.”

Read More About How to Fight Cancer that Runs in the Family

In 2018, Jordan Stiteler became a Healthy Nevada Project advocate. Her DNA results revealed that she had Familial Hypercholesterolemia (FH). FH is a genetic condition that can cause high cholesterol. Since then, Jordan’s taken action to lower her cholesterol and make her family aware of this potentially dangerous condition. Read Part I of Jordan’s story Taking Control of High Cholesterol Looking at Jordan, an active young mother, you would never suspect she has high cholesterol. However, because of FH, Jordan’s cholesterol levels are unusually high. She chose to take action when learning of her FH gene, in order to maintain her long-term health. Jordan started by exercising more and eating healthier. “I’ve definitely been checking all the labels to see if the food has a lot of cholesterol, trans fats, or saturated fats,” she explains. She now eats a 100% plant-based diet which helps to lower her cholesterol naturally. Additionally, Jordan partnered with Dr. Michael Bloch, a lipid specialist, to monitor and manage her cholesterol. She told Dr. Bloch that she and her husband were planning on having a second baby. With this in mind, he helped Jordan create a plan to accommodate her pregnancy. Several months after giving birth to her beautiful daughter Logan, it was time to revisit her cholesterol treatment plan. Dr. Bloch prescribed Jordan a statin called Lipitor. It successfully cut her total cholesterol by half in just three months. “I had blood work done in November 2019 and my total cholesterol was 293 (normal is less than 199). I started taking cholesterol medication in February 2020. I had blood work done in June 2020 and my total cholesterol was 149, ” Jordan shares. “My LDLs went from 219 to 78! I am so grateful that the medication worked so well and so quickly! It’s a weight lifted off of my shoulders.” Although Jordan no longer limits herself to a strictly vegan diet, she is mindful of what she eats and how it affects her cholesterol. She’s thrilled that her cholesterol is now at a healthy level!

Read More About Taking Control of Her High Cholesterol and Health

What exactly is the relationship between genetics and disease? Powered by Renown Health, the Healthy Nevada Project is one of the most visible genomic studies in the United States. They are recruiting participants here in northern Nevada to understand the relationship between genetics and nonalcoholic liver disease. Joseph Grzymski, Principal Investigator at the Healthy Nevada Project and Chief Scientific Officer at Renown Health, shares why this study is so important and who should take part. Many people are aware that heavy drinking can lead to liver disease. Yet they are unaware that other types of liver disease are not caused by alcohol consumption. These types of liver disease are more difficult to diagnose but are equally dangerous. What is NASH? A build-up of fat causes nonalcoholic Fatty Liver Disease (NAFLD) in the liver. The most dangerous form is called Nonalcoholic Steatohepatitis (NASH). It causes inflammation and damages liver cells, leading to fibrosis, scarring of the liver, and decreased liver function. If NASH goes untreated, irreversible liver damage can occur, leading to cirrhosis, cancer, or liver failure. These conditions can be fatal. What’s most concerning about NASH is that the symptoms don’t typically cause pain and aren’t noticeable. The good news is that a new local study is raising awareness about this disease by recruiting at-risk people for NASH. Am I at risk for developing NASH? The following factors put you at risk: Obesity Type 2 diabetes Metabolic syndrome High blood lipids, such as cholesterol and triglycerides Does having a family member with nonalcoholic liver disease increase my risk? We do not know a lot about inheriting NASH, although a lot risk factors run in families. One goal of this study is to better understand the genetic component of NASH. There are certainly other risks too, such as environmental and behavioral risk factors. However, we don’t yet have a good grasp on how these impact NASH risk. How is NASH diagnosed? Diagnosis is traditionally done with either a liver ultrasound or biopsy. However, both procedures are expensive and the invasive biopsy has risks. Therefore doctors often use risk factors or less invasive blood tests for diagnosis. This NASH study will include a new blood test called the enhanced liver function (ELF) test. Doctors and researchers have data suggesting that the ELF test is a better diagnostic test for NASH risk. Conducting this cutting-edge test with study participants allows them to share results with their doctors to ensure the best care. What can I do to reduce my NASH risk? Limiting exposure to the risk factors of NASH often lowers risk. Eating a healthy diet, maintaining a recommended weight and exercising regularly can proactively lower your risk.

Read More About Nonalcoholic Liver Disease and Genetics: Is There a Link?

In recent years, workplace violence against healthcare workers has been on the rise. According to the Occupational Safety and Health Administration (OSHA), about 75 percent of nearly 25,000 reported annual workplace assaults occur in healthcare and social service settings. Those who don’t work in healthcare may be surprised to learn that violent altercations are so common in our field. Hospital settings can create fear and stress for patients and their families. Pain, mind-altering medications and drugs, and difficult prognoses can amplify these feelings. While inappropriate responses may be understandable, violence cannot be tolerated. As the leader of a health system, protecting our employees is an issue that I take seriously. Reporting Workplace Violence Unfortunately, sometimes employees don’t report dangerous incidents fearing they might be blamed, or not realizing it’s a reportable offense. At Renown Health, we take these events seriously. We have clear, mandatory policies and protocols for reporting and investigating violent incidents. Each incident is investigated to ensure follow through and accountability. We also teach de-escalation skills to our hospital security teams, clinicians, and other frontline employees. As an added layer of protection, Renown Health has a first-rate security team that closely monitors activity on our campuses, addressing potential issues before they escalate. Our organization values our partnerships with community organizations including local law enforcement agencies like the Washoe County Sheriff’s Office and the Reno Police Department. Renown Health maintains a close relationship with these partners, and we alert them when our care teams experience an increase in violent incidents. I also recognize that workplace violence is a national problem that demands collaborative solutions. That’s why I am also proud to serve as a member of the American Hospital Association’s Hospitals Against Violence Advisory Committee. Nurses, doctors, paramedics, and frontline health workers care for us every day. It’s our responsibility to support them by ensuring they feel safe at work.

Read More About Addressing the Threat of Workplace Violence in Hospitals

Over the past year, the safety of healthcare providers has received more public attention than ever before. Throughout the COVID-19 pandemic – and particularly in the early days – the public learned about the vital role of personal protective equipment (PPE) and other important processes that keep healthcare workers safe and healthy. However, people may be surprised to learn that germs and viruses are just one of the many risks that healthcare professionals face every day.  Many people are fortunate enough not to have to worry for their physical and mental wellbeing when they go to work. Unfortunately, this is not the case for countless healthcare workers across the nation, for whom workplace violence is a daily concern. According to the American Hospital Association, healthcare workers are four times more likely to experience serious workplace violence as people in other industries. This is particularly troubling knowing that healthcare workers have dedicated their careers to serving others, putting their communities first day in and day out. Responding to the Challenge of Workplace Violence At Renown, we have no tolerance for abuse against our employees. As an organization, we have several systems in place to support and protect our staff. During staff orientation, we provide classes to prepare employees to prevent and de-escalate verbal or physical abuse. We also offer ongoing education to train our staff to respond to violent situations. If an incident does occur, our violence prevention task force reviews incidents and ensures the impacted employees receive resources and counseling to help them process what has occurred.   As a leader, I am continually impressed by our team’s desire and ability to support one another. However, I know that it is my responsibility to protect our team. No one should have to face harassment or abuse – in any form – in their workplace, and I think about the risks our employees face every day. I believe so much in this cause that I volunteer on the American Hospital Association’s Hospitals Against Violence steering committee, which works to understand the causes behind violence against healthcare workers and develops tools and processes to prevent these incidents from occurring.

Read More About Workplace Violence: Protecting Healthcare Workers

Over the past year, the safety of healthcare providers has received more public attention than ever before. Throughout the COVID-19 pandemic – and particularly in the early days – the public learned about the vital role of personal protective equipment (PPE) and other important processes that keep healthcare workers safe and healthy. However, people may be surprised to learn that germs and viruses are just one of the many risks that healthcare professionals face every day. Many people are fortunate enough not to have to worry for their physical and mental well-being when they go to work. Unfortunately, this is not the case for countless healthcare workers across the nation, for whom workplace violence is a daily concern. According to the American Hospital Association, healthcare workers are four times more likely to experience serious workplace violence than people in other industries. This is particularly troubling knowing that healthcare workers have dedicated their careers to serving others, putting their communities first- day in and day out. What is Considered Workplace Violence? The World Health Organization (WHO) defines workplace violence as, “Incidents where staff are abused, threatened, or assaulted in circumstances related to their work, including commuting to and from work, involving an explicit or implicit challenge to their safety, well-being, or health.” WHO considers both physical and psychological harm, including attacks, verbal abuse, bullying, and both sexual and racial harassment, to be workplace violence. Responding to the Challenge of Workplace Violence At Renown Health, we have no tolerance for abuse against our employees. As an organization, we have several systems in place to support and protect our staff. During staff orientation, we provide classes to prepare employees to prevent and de-escalate verbal or physical abuse. We also offer ongoing education to train our staff to respond to violent situations. If an incident does occur, our Violence Prevention Task Force reviews incidents and ensures the impacted employees receive resources and counseling to help them process what has occurred. We are among the first in the nation to have instituted a Zero Tolerance policy on workplace violence. This policy is in place to let our employees know that we have their backs in preventing workforce violence and we will address it assertively if the environment becomes unsafe. As a leader, I am continually impressed by our team’s desire and ability to support one another. However, I know that it is my responsibility to protect our team. No one should have to face harassment or abuse – in any form – in his or her workplace. I believe so much in this cause that I volunteer as Chair of the American Hospital Association’s Hospitals Against Violence steering committee, which works to understand the causes behind violence against healthcare workers and develops tools and processes to prevent these incidents from occurring. Violence was already a concern facing health care organization leaders prior to the COVID-19 pandemic. Now, the ongoing health crisis has elevated tensions. Health care is an industry like no other, with our most precious resource being our employees. As a community, as patients and family members, we have an obligation to ensure that all healthcare workers are safe while they go about their work. This starts with understanding, communication and unequivocal support for the profession. This month we launched the Be Kind campaign across Renown, a reminder to all of the importance of values like patience, kindness and gratitude. If you would like to join us in recognizing a healthcare hero, please submit your thoughts here. Thank you for working with us, and all healthcare providers, to create and maintain places of health and healing for all – and for kindly caring for those who care for you.

Read More About Kindly Care for Those Who Care for You

On behalf of Renown’s more than 7,000 employees, we are thrilled to introduce our healthcare system’s next CEO and President, Brian Erling, MD, MBA. Dr. Erling joins Renown after working for more than 20 years in Colorado, most recently as the CEO and President of Penrose-St. Francis Health System in Colorado Springs for Centura Health. “I am so excited to join Renown Health at this important time. Healthcare and our economy are amid a major transformation, and Renown Health is very well positioned for the future,” Dr. Erling said. “Our ongoing success will hinge on our ability to establish positive and productive relationships, maintain high-quality patient clinical outcomes and experiences, reduce healthcare costs, encourage innovation and improve access and affordability for patients and members.” Q: Let’s start at the beginning. When did your interest in healthcare first begin? A: Believe it or not, I started my healthcare career during high school in Minnesota when I worked as a nursing assistant. I then worked as a monitor tech while pursuing my undergraduate degree in biology from Drake University in Des Moines, Iowa. Q: Where did you go to medical school, and what was your first job after training? A: After graduating from The John Hopkins University School of Medicine and spending three years at the University of Virginia for my residency, I spent more than a decade in the emergency department at a level 1 trauma center. Q: Does your experience as a physician impact your approach to healthcare leadership? A: Yes, absolutely. I have worked my fair share of nights, weekends and holidays, and I know the sacrifices healthcare workers – and their families – make to care for our communities. I will never take it for granted. I also understand how complex healthcare organizations are, and I have experienced these complexities from both the clinical and non-clinical sides. I have provided clinical leadership for a large, regional health system and understand that quality, safety and innovation come from the people doing the work, not from a corporate office. But you also need strong managers and leaders to facilitate and prioritize the work while providing support and coaching. Q: What is the key to a successful healthcare system? A: Teamwork. In fact, being part of a high-performing, mission-driven team is my number one motivation. It’s what gets me up in the morning and why I work in healthcare. I view our greatest resource to be our people, meaning Renown’s more than 7,000 employees. Modern technologies – such as fancy robots and imaging equipment – are essential and pretty cool, but they are not why our patients choose us. They come for trusted care in their hometown. Q: Renown Health is going through a lot of exciting changes right now. What is one thing that excites you about joining this healthcare system in a rapidly expanding area of the country? A: I am very excited about the new partnership with Renown and the University of Nevada, Reno School of Medicine. While still in its infancy, it provides the platform for us to be the center for training, research and tertiary care for the region and beyond. Q: What is something you have learned from working with CEOs at other healthcare systems? A: Healthcare leaders often have a short half-life, but that is not me. I believe it is difficult to create and move an organization toward a unified vision when your leader changes every few years. As my track record will support, this is not my style. I have been in Colorado for over twenty years and now look forward to making Reno and Renown my home for years to come. Q: As you know, Hometown Health is Renown’s health insurance arm. How does equitable access to insurance fit into a person’s and a community’s overall well-being? A: Most health systems would love to have their own health plan. The reality is that you cannot meaningfully improve the health of the population without managing value and risk. We are fortunate to have Hometown Health as part of Renown Health, and in our community, and I am excited to work with Bethany and the team to fulfill the mission of the organization. Q: What does working at a not-for-profit healthcare system mean to you? How does it differ from the for-profit sector? A: I have worked in for-profit and not-for-profit healthcare. Renown is unique as the only not-for-profit health system in the market. What that means is that we invest every penny earned back into caring for our community. We don’t send money to shareholders in California or Pennsylvania, we invest it right here in Nevada. Not only is a not-for-profit healthcare organization where I want to work for, but it is where my family and I want to go for care. Q: What do you like to do for fun? A: I love spending time with my wife and three adult children. I met my wife, Jessica, while attending medical school in Baltimore. She was working as a nurse in the surgical ICU, and I was smitten. I offered to help her with a 3 a.m. bed linen change and bath for our trauma patient, and the rest was history. I also love exploring the outdoors, especially snowboarding!

Read More About A Q&A with Dr. Brian Erling, CEO & President of Renown Health

The Healthy Nevada Project (HNP) is one of the most visible genomic studies in the United States, and guess what? Renown Health powers it! The Healthy Nevada Project (HNP) aligns with Renown's goal to do the best for our patients. The genomic study is at no-cost for Nevadans and gives participants insight into different genetic traits, including results on three prevalent and serious health conditions known as CDC Tier 1 conditions. CDC Tier 1 Conditions Include: Hereditary Breast and Ovarian Cancer Syndrome (HBOC) Lynch Syndrome Familial Hypercholesterolemia (FH) Not only does HNP give participants insights into their genetic background, but it also facilitates Renown's ability to study population health. Research lays the foundation for the future of medicine, and Renown's HNP is on the cutting edge of genetic research. We do this by providing skilled researchers access to studies for the diseases that currently have limited treatment, including nonalcoholic steatohepatitis liver disease or NASH. For example, the observational NASH study helps researchers understand genetic links to the disease. Make an Appointment to Get Screened If you haven't already, join the over 55,000 HNP participants and make an appointment to have yourself screened. You can schedule a screening appointment through MyChart. Click “Schedule an Appointment" and select Research Appointment - Genetic Screening. Prior to your appointment, please complete e-Check-in and complete your consent form.

Read More About What is the Healthy Nevada Project?