In May 2016, Tony Slonim, MD, DrPH, met fellow New Jersey native Joe Grzymski, PhD, at a Starbucks for coffee. Dr. Slonim, CEO of Reno, Nev.-based Renown Health, said he expected to trade stories about their home state, but they soon found their professional interests as compatible as their personal ones.
"Like all good things, it started at Starbucks over a coffee on a Saturday morning," Dr. Slonim said, "As we let our minds expand and started thinking about complementary ways we could collaborate, this idea came up."
This idea is a partnership between Renown and the Desert Research Institute, where Dr. Grzymski is senior director of applied research.
The duo began to think of ways they could combine the clinical data 946-bed Renown had on hand with the DRI's environmental data to better understand the ways outside factors affect health outcomes in their community.
But the idea didn't stop there. The pair also recognized that social determinants play an equally influential role in shaping a person's health, so they made sure to include social data from the Governor's Office of Economic Development in their new project, which did not yet have a name, but more importantly had a purpose.
"If we believe in population health, and the vision for population health, we've got to do a better job of understanding the health and the wellbeing of the people we're serving," said Dr. Slonim. "As an organization that's got a large market share, it's incumbent upon me as the CEO to think about how to use the most efficient resources for the most benefit for people that need it."
At first, the collaboration was seen as a data-sharing project that would connect skilled researchers and analysts at the DRI with a wealth of combined information that had been inaccessible to a single provider in the past. However, it was only once Dr. Slonim and Dr. Grzymski took their idea to the 2016 BIO International Convention in San Francisco that they were able to find a third partner to provide them with yet another data set that would help them fully see the big picture of a person's health.
Representatives from retail genetics firm 23andMe approached Dr. Grzymski following his talk at BIO. The company offered to provide genetic testing and sequencing for the project. Dr. Grzymski jumped at the opportunity, which would enrich the already robust data collection he and Dr. Slonim had begun to compile.
With genetic information as a fourth pillar of their potential data set, Renown and the DRI founded the Renown Institute for Health Innovation. The IHI's most important initiative would go on to be named the Healthy Nevada Project.
At a September 2016 press conference, Dr. Slonim and other IHI leaders teamed up with Nevada Gov. Brian Sandoval to announce that the first 5,000 Reno residents who signed up to submit genetic samples would receive free access to the test results. Dr. Slonim believes offering this access to community members is what encouraged 5,000 people to sign up in only the first 24 hours of the enrollment period. With such an enthusiastic response, the leaders at the IHI decided to open up 5,000 more slots, which took one more day to fill. In only 48 hours, the Healthy Nevada Project had succeeded in enrolling 10,000 local residents to submit samples for genetic testing.
The project was off and running — quickly. And Dr. Slonim's work was only just beginning.
Once 23andMe completed genetic sequencing of all 10,000 study participants in December, the Healthy Nevada Project still faced a looming question: What to do with all the data they'd collected?
"One-hundred more people per 100,000 die of cardiovascular disease in northern Nevada than national estimates. Our cancer rates are significantly higher and nobody knows why. So [we're] trying to understand what the backdrop and the context is," Dr, Slonim said. "Is it the mines that we have here? Is it the weather patterns that change because we're in a valley? Our air pollution is higher, our particulate matter is higher — is that what causes lung cancer? We're trying to figure this out, but you can't do anything without data, so we started there."
Dr. Slonim understands epidemiologists and analysts will have to spend many careful hours with the data to come to any concrete conclusions, but he believes the Healthy Nevada Project represents an essential first step for the future of the healthcare industry. If he and his colleagues could begin to harness the power of data in EHRs, then he sees a world of untapped potential that can help his community improve their health while also improving Renown's organizational efficiency.
"This is the ultimate in strategic planning. If I figure out that our community is more at risk for cardiovascular disease 10 years from now, I can be thoughtful about how I go about recruiting cardiologists. If I know that the population is growing in pediatrics, I can start a program for pediatric residents at the medical school and grow my own pediatricians," Dr. Slonim says. "The horizon for planning can be kept in view because we're learning about our population's health and disease. The second reason why I did this is because it's the best way to engage consumers in their own healthcare to modify their behaviors."
Dr. Slonim's advice to hospital leaders looking to improve their capacity for innovative data concepts is simple: Take the first step. For the most part, the benefits of the Healthy Nevada project still lay ahead, as it has been only 15 months since that coffee meeting, but the game-changing potential cannot be understated. Dr. Slonim is confident that putting in the work to collect and analyze this comprehensive data will revolutionize the way Renown cares for its patients, and he believes other providers can follow suit.
"If you're a large contributor to your market in healthcare with full range of integrated services across the continuum, get the environmental data. Get partnerships with the social data," Dr. Slonim says. "Figure out how you can exercise your clinical EMRs and the great repository of data that are in there and put them in a big data warehouse and figure out how to analyze them. We're not using predictive analytics in healthcare the way that other industries are, and we need to be better at that."
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