The Healthy Nevada Project is moving forward with its population health and personalized medicine initiatives, delivering genetic results to thousands of state residents.
The ambitious project is starting to deliver results with great impact to both individuals and the state health system, says Anthony D. Slonim, MD, DrPH, FACHE, president and CEO of Renown Health, a healthcare network serving Nevada and northeast California. He also is president of the Renown Institute of Health Innovation in Reno, NV.
Nevada started the unique, community-based population health study in 2016, incorporating clinical, genetic, and environmental data to develop personalized care for state residents. The first phase involved 10,000 people, and phase two addressed genomic sequencing for an additional 40,000 Nevadans. (For HPR’s earlier report on the project, go to: https://bit.ly/2FwQr9R.)
“We are now providing clinical results for Tier 1 genetic conditions, which include familiar hypercholesterolemia, BRCA 1 and 2, and Lynch syndrome, which contributes to colon and endometrial cancer,” Slonim says. “We present those results with genetic counseling and clinical algorithms to follow to either address their risks by changing behaviors or through screening and early diagnosis.”
The rates for hypercholesterolemia are in line with expectations from large-scale studies so far, he notes, but the Healthy Nevada Project is watching for any deviations that could signal a particular need in the state.
“At the individual level, we are changing people’s lives, so it is important to provide the right kind of counseling and resources as we deliver these test results,” Slonim says. “But at the same time, we are considering what the results mean on a macro level. Does our community have more women with the BRCA genes than other communities, and if so, does that mean we need to allocate resources in order to better serve those residents?”
One of the participants with a genetic marker for familial hypercholesterolemia is 29 years old, Slonim notes. Her father died of a stroke and her grandfather died of a cardiac event, but she did not know she had the gene.
As a result of the testing, her physician put her on a higher-than-normal dosage of cholesterol medication, and her child will be tested also.
“This an example of how these results can be life-changing. She can alter her diet and lifestyle, get the right medical care, and hopefully avoid dying from a cardiac event in her mid-forties,” Slonim says.
- Anthony D. Slonim, MD, DrPH, FACHE, President and CEO, Renown Health, President, Renown Institute of Health Innovation, Reno, NV. Phone: (775) 982-5529. Email: [email protected].