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    • Tuesday, Dec 21, 2021

    A One Year Reflection: Thousands of Health Care Workers and Northern Nevadans Vaccinated Against COVID-19, Offering a Beacon of Hope This Holiday Season

    The best protection continues to be getting a COVID-19 vaccine and booster, wearing a mask, staying at least 6 feet away from others, avoiding crowds, and washing your hands often. For the thousands of physicians and health care workers of Renown Health, this week is etched into the pandemic timeline as the start date of a nationwide wave that signaled the first vaccinations against COVID-19 and a beacon of hope for the future. A year ago, the nation’s health care systems in communities across the U.S. first began vaccinating physicians and health care workers caring for patients with COVID-19, and thousands received their first vaccine. One year ago, Renown Health, the Washoe County Health District (WCHD), the state and the Centers for Disease Control and Prevention (CDC) began to distribute the initially available, limited supplies of the COVID-19 vaccines in Washoe County. Media representatives viewed the first healthcare workers as they obtained their first dose of the life-saving vaccines. Luis Martinez, first health care worker vaccinated, now plans to attend medical school Luis Martinez, who served on the front-line of the pandemic at Renown Regional Medical Center, received the first of his Pfizer-BioNTech vaccine a year ago this week, after it received emergency use authorization from the Food and Drug Administration. He received the second and final vaccination in the series 21 days later. Luis has been at Renown since 2016, where he started as a phlebotomist and has been encouraged to advance his career in the medical field. He works as a technician on Renown’s Clinical Decision Unit — a short stay unit within the hospital for people who need clinical care, but do not need admittance to the hospital. Luis worked with patients and clinicians in the Clinical Decision Unit for a year before requesting to work in Renown’s Alternate Care Site, built in the Mill Street parking structure as a place to care for patients recovering from COVID-19 before they returned home. Today, Luis is working to fulfill his dreams of becoming a doctor. He took the Medical College Admission Test® earlier this year, interviewed virtually and applied to 24 medical schools. Luis has shadowed physicians in a number of medical fields, including internal medicine, emergency medicine, cardiology and orthopedics, and would be thrilled to train in any one of those areas. As for medical school, Luis was excited to hear about Renown’s new clinical affiliation with the University of Nevada, Reno School of Medicine (UNR Med). He is enthusiastic about becoming part of the next generation of Nevada's health care professionals, and his first choice is UNR Med. He expects an admission decision by UNR Med this winter. If that doesn’t work out, he says, he has an interview with leaders at the Kirk Kerkorian School of Medicine at UNLV in January. Luis is bilingual and understands that Nevada continues to face a shortage of physicians and affordable medical care. He volunteers with CARE Chest of Sierra Nevada, a non-profit organization that provides free medical equipment, supplies, and prescription assistance to underserved populations when he is not working at Renown. His dream is to graduate medical school and stay in the community to provide medical care as a physician. Luis knows the importance of excellent medical care, and the importance of the vaccines against COVID-19. Last October, Luis turned 33 and contracted COVID-19 after a family birthday party. Because of his experience, his interest in medicine and his research, Luis obtained his COVID-19 vaccines- and his booster, and is pleased that everyone in his family is triple vaccinated too. He says they are all feeling well and looking forward to being together at the holidays. “As we celebrate this holiday season, we give thanks for Luis and the thousands of health care heroes who have been fighting this pandemic with care and compassion; continuing to safely screen, diagnose, care for and vaccinate thousands of employees and community members,” said Tony Slonim, MD, DrPH, President & CEO of Renown Health. “It has been an honor to assist local and statewide health partners in the herculean vaccination effort. Over the past year, Renown’s vaccine team administered more than 58,000 dose 1 and dose 2 vaccinations to Nevadans ages five and older. We continue to work closely with our community health leaders and are always ready to assist. We are proud to be part of the solution for our community and pleased to have made a genuine difference in the health and well-being of others throughout this unprecedented time in our history.” Renown continues to use current local and national data, analytics, and public data sets for predictive modeling in service to our community. When there is heightened concern around an illness, enhanced infection prevention strategies are in place to ensure Renown is ready with the appropriate supplies and alternate plans should the need arise. Vaccination is still the best protection against Omicron and Coronavirus Today also marks a dark new milestone for Washoe County — over 1,010 confirmed COVID-19 deaths, and over 70,549 total cases in our population of nearly 500,000. The bright spot is that over 65,714 people have recovered in Washoe County, although many still grapple with long-term effects of the illness. The world and the U.S., continue to experience an increase in COVID-19 cases and hospitalizations with the highly contagious Omicron variant, which now accounts for 50 percent of the coronavirus cases in parts of the country. In some areas, there is a significant stress on the hospital system, particularly where vaccination rates are low. “The most important action you can take to protect yourself from the Delta and Omicron strains and the COVID-19 virus is to get fully vaccinated,” says Susan Lee, DO, MBA, Chief Medical Officer, Acute Care. “The COVID 19 virus and its related strains are preventable and controllable through safe and effective COVID-19 vaccines, which are free and now widely available in our area. The CDC recommends all people 5 years and older be vaccinated against COVID-19. Data shows that nearly all COVID-19 deaths are now occurring among unvaccinated individuals.” A list of providers in our area offering vaccines is available at vaccines.gov.” “The best protection from COVID-19 has been a combination of getting a COVID-19 vaccine, wearing a mask, staying at least 6 feet away from others, avoiding crowds, and washing your hands often,” says Amy McCombs, MSN, RN, CCRN, CNML, vice president of Quality for Acute Services for Renown, and a champion of the vaccination effort for Renown. “No one tool alone will stop this pandemic; it will take a combination of all of us using all of these efforts to fight the spread of this virus, especially through the holidays.” “Vaccinations have been a game-changer in terms of improving the health of our community,” said Rahul Mediwala, MD, Chief Medical Officer, Health Services. "Given the demands of this COVID-19 pandemic, we have been pleased to help in the fight by providing vaccinations. Our goal a year ago, was that all Renown physicians; employees and their family members; and all Hometown Health members and Renown patients interested in receiving the vaccine would have an opportunity to be vaccinated, we are excited to help make that dream a reality for all.” The COVID-19 vaccine is now mandatory for all Renown employees in an effort to protect those who are ill and physically vulnerable, and ensure a safe environment for patients and health care workers. Renown is covering all costs of the vaccine, and it is being offered free of charge to employees. As of today, 97% percent of all 6,750 Renown Health employees are vaccinated or have an approved exemption or deferral. “This year was a year no one will forget. For everyone- and for our health care workers at Renown, the year presented countless challenges and opportunities. Those of us who choose healthcare as our life’s work answer a true calling to serve others; this field requires a self-less commitment and a tireless dedication to caring for people when they are at their most vulnerable,” said Renown’s Chief of Staff, Sy Johnson, MBA. “I applaud the entire team- every physician, nurse and health care hero for their valor, their strength and perseverance in serving our patients and community during these unprecedented times.” What follows are highlights of some of the most remarkable moments and events that have taken place at Renown Health over the past year in relation to the response to COVID-19. Temporary Deployable Medical Structure Outside Renown Regional Emergency Department On March 12, 2020, Renown erected a deployable medical facility to serve as a respiratory illness evaluation and screening center for Emergency Room patients at Renown Regional Medical Center. A similar tent was also set up outside the Emergency Room at South Meadows Medical Center. An additional layer of protection, this proactive measure helped to care for people with symptoms of respiratory illness, and to protect patients and staff in the Emergency Department and other areas of the hospital. The tents were dismantled on January 20, 2021. (See photo here.) Alternate Care Site at Mill Street Parking Structure at Renown Regional As many communities across the nation experienced an increase in COVID-19 cases, including significant surges in hospitalized patients, Renown’s leadership had the foresight to create an Alternate Care Site (ACS) in the Renown Regional Medical Center Mill Street Parking structure. The ACS served additional hospitalized patients and allowed caregivers to remain on campus and still have access to existing hospital infrastructure such as lab, pharmacy, imaging, food services and other critical services. This solution also supported an efficient level of care escalation and other emergent interventions as needed. After just 10 days of intricate construction, including flooring, electrical infrastructure, lighting, water, technology and wall partitions, the ACS was completed on April 3, 2020 with space to hold up to 1,400 patients. On Nov. 12, 2020, Renown opened the ACS to serve additional hospitalized patients diagnosed with COVID-19 who were clinically stable or improving. Healthcare workers at Renown cared for hundreds of patients in this site. In early Jan. 2021, the remaining patients returned home. The Site has been decommissioned and leaders expect the area to be available for additional parking later this winter. (Alternate Care Site B-Roll.) Renown invests in Remote Patient Monitoring (RPM) ‘Hospital at Home’ Monitoring Systems Appropriate patients (including those recovering from COVID-19) are now offered a telehealth solution using wearable, continuous pulse oximetry, and the convenience of being in their own homes, with the confidence and security of knowing that Renown clinical staff are closely monitoring their health data through the Renown Transfer and Operations Center, and regularly communicating with them through their recovery process. The Renown Transfer and Operations Center spans 6,000 square feet, and is one of the largest centers of its kind in the nation, equipped with 28 high-definition dashboards on the front wall, two in the center of the room and four hanging monitors toward the back. Large plasma screens display important metrics such as patient vital signs, bed availability, facility capacity, staffing, technology and more. Registered Nurses and dispatchers continuously monitor activity around the clock, across Renown’s 100,000 square mile service area, 100+ locations and partner facilities to make the best decisions for patients, providers and care teams. “LOVE” Makes its Way to Renown On April 16, 2020, during a time of darkness and uncertainty, Artown loaned the “LOVE” sculpture, a one-ton, welded-aluminum artwork created by artist Laura Kimpton and fabricated by Jeff Schomberg to Renown, where it lit up Regional Medical Center’s main entrance on Mill St. The sculpture formerly debuted at Burning Man in 2019. On July 13, 2020, thanks to the support of former board chair and community supporter, Blake Smith and the Keyser Foundation, “LOVE” continues to glow in Renown’s signature purple every evening, shining brightly for patients, employees, visitors and passersby to enjoy. Throughout the pandemic, this sculpture has served as a source of inspiration, hope and positivity for our community. (LOVE sign B-Roll.) When Words Fail, Art Speaks Recognizing art’s powerful healing capabilities, Renown collaborated with prominent artist and fine art photographer, Anicia Beckwith, to immortalize the many battles fought against and amidst COVID-19 within the healthcare system’s walls. Beckwith captured portrait images of Renown caregivers, patients and their loved ones, showing raw and touching scenes from the COVID Intensive Care Unit, Emergency Departments, Neonatal Intensive Care Unit, Wilbur D. May Pediatric Intensive Care Unit and the Alternate Care Site field hospital. A group of Renown caregivers hold a COVID patient’s hand. Tears well up in their eyes as the patient takes his last breath. Care providers respond to a patient’s only request – a facial shave. The man beams at the sight of his freshly groomed face, and is visibly touched by the tender care he received to make it happen. Lupe, an environmental services worker, takes special care in her efforts to clean and sanitize patient rooms—a craft she has perfected and taken pride in for the 25+ years she’s worked at Renown. These are just a few of the captivating moments Beckwith illustrates through her art. Beckwith’s full photo gallery of images from Renown are located here; and downloadable visual assets are available here. Evolving in an Ever-Changing World: Long-Term Remote Work for Renown Employees The COVID-19 pandemic pushed healthcare leaders throughout the world to determine how best to provide care in this ever-changing environment. Leaders in Renown’s Human Resources department evaluated the thoughts and opinions of employees working remotely throughout Renown Health. Due to the positive feedback from employees, including decreased commute times, fewer distractions, improved work-life balance and a reduced carbon footprint, over 700 Renown employees will continue working remotely. Renown Offers In-House COVID Testing In June 2020, the Renown Laboratory team sprang into action to help meet Washoe County residents and businesses’ growing demand for COVID-19 testing. Renown invested in expanded staffing and in-house testing capabilities to be able to swab and process up to 1,000 COVID tests for patients each day, with return of results within hours. Renown’s CEO, Dr. Tony Slonim also collaborated with the Mayor’s COVID-19 Task Force, local faith and community leaders beginning in Oct. of 2020 to address health equity by providing free COVID-19 testing for communities of color. (Lab B-Roll). An Extraordinary Year of Service Renown’s leadership remains steadfast commitment to keeping our community safe. “We thank the community for standing by us and helping us all emerge as stronger people with hope for the future. We continue to fight the good fight,” said Dr. Slonim. “With COVID now imbedded into our daily lives, it’s remarkable to reflect on the progress we’ve made and the obstacles we’ve overcome. I will be forever grateful for the precautionary measures, innovation, and acts of service and love implemented by our dedicated team over the past two years. We hope by demonstrating our caring values and exhibiting hope and determination, we are inspiring others.” Stay Up-to-date on COVID-19 Renown Health is prepared to safely screen, diagnose and care for patients with respiratory illness, including COVID-19. To stay up-to-date on communications regarding Renown’s distribution of the COVID19 vaccine, FAQs and the scientific evidence behind the vaccine, visit https://covid.renown.org/ Join the Renown team Renown Health remains committed to hiring key roles in our organization to support the health and well-being of our community. To join the Renown family to Fight the Good Fight, apply on line at https://careers.renown.org/ Support the Renown team Renown Health, a charitable, not-for-profit organization, is grateful for our community’s support during these unprecedented times. If you are interested in supporting Renown Health, a charitable, non-profit health organization, please consider giving to Renown Health Foundation. Donations are accepted through the following ways: Make a gift at www.renown.org/give Call Renown Health Foundation at 775-982-5545 Mail a check to Renown Health Foundation, 1155 Mill St., O2, Reno, NV 89502 Venmo: @RenownFoundation     About Renown Health Renown Health is the region’s largest, locally governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. With a diverse workforce of more than 6,500 employees, Renown has fostered a longstanding culture of excellence, determination and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the region’s largest, locally owned not-for-profit insurance company, Hometown Health. Renown is currently enrolling participants in the world’s largest community-based genetic population health study, the Healthy Nevada Project®. For more information, visit renown.org.

    Read More About A One Year Reflection: Thousands of Health Care Workers and Northern Nevadans Vaccinated Against COVID-19, Offering a Beacon of Hope This Holiday Season

    • Thursday, Dec 17, 2020

    First COVID-19 Vaccines Administered to Physicians Today

    This week, many of the nation’s health care systems in communities across the U.S. began vaccinating physicians and health care workers caring for patients with COVID-19. Many of these health care heroes have been on the front-line of this pandemic and working around-the clock over the last ten months. Vaccinations signal hope for the future Here in Washoe County, today is the highly anticipated start date of what public health and medical experts hope is a nationwide wave of vaccinations that signal the beginning of the end of the COVID-19 pandemic.  Today’s good news from Renown coincided with a dark new milestone for Washoe County—384 confirmed COVID-19 deaths, and over 13,579 active cases in our population of nearly 500,000. COVID-19 positivity test results and hospitalizations continue to be high across the country, our state and here in northern Nevada; straining hospital capacity, physicians and healthcare workers.  Today we saw a bright light at the end of this dark tunnel. Renown began vaccinating health care workers caring for patients with COVID-19, and invited media to view the first vaccinations of those on the front-line of COVID-19. One vaccine, a Herculean effort of thousands “Although the vaccination process as you see it here looks relatively simple, it took a herculean logistical effort to implement the COVID-19 vaccination process that has begun today,” said Tony Slonim, MD, DrPH, President & CEO of Renown Health. “Today, thanks to the synchronized efforts of thousands of people and organizations across the country, we give thanks for this vaccination provided to Luis Martinez, an excellent ambassador for the thousands of healthcare heroes caring for patients with COVID-19. The health and safety of our staff is our top priority, and we remain steadfast in our determination to fight the good fight for our community.”  Luis, on the front-line of the COVID-19 pandemic, receives 1st vaccine from Renown Luis Martinez received the 1st of his Pfizer-BioNTech vaccine which received emergency use authorization from the Food and Drug Administration last week. He will receive the second and final vaccination in the series in 21 days.  The first dose of vaccine was given to Luis outside of his vehicle so cameras could capture the experience. Renown’s COVID-19 Vaccination process includes pre-scheduling physicians and employees through the Epic MyChart electronic medical record used by Renown. Employees are masked, and in their personal vehicles, as they drive through the vaccination site. Each physician and healthcare worker provides their verification, identification, documentation and consent. They then extend their upper arm to receive the Pfizer vaccination. Following the receipt of the vaccination they have a 15-minute observation period to assure they do not experience any immediate side effects. These Tier 1A healthcare employees were encouraged to schedule their vaccination after their completed work schedule to have time to rest. As with all vaccinations, there is a potential for injection site reactions (redness, swelling and pain) as well as fever, fatigue, headache, chills, vomiting, diarrhea, muscle pain and/or joint pain. Fever is not an infrequent side effect, especially on the 2nd dose, so these vaccinated employees will self-monitor their temperatures, as they cannot work at Renown with a fever. In addition to Luis, you’ll see, first in his truck- Dr. Bret Frey, representing the Medical Staff and Emergency Medicine physicians at Renown; Nurse Matt Polak, Supervisor of Clinical Nursing of Renown’s Respiratory Intensive Care Unit representing Renown nurses; Holly Irwin, a Clinical Respiratory Therapist in her vehicle; Alexis Bertauche, Respiratory Specialist in his vehicle; Eric Whitney, the supervisor representing the 168 members of Renown’s Environmental Services team who have performed extensive disinfecting measures throughout the pandemic, physician representatives from partners at UNR School of Medicine, Reno Orthopedic Clinic, the Surgery Center of Reno and across the community.  Brighter days ahead for Luis Luis has been working in Renown’s Alternate Care Site in the Mill Street parking structure since it opened to patients in mid-November. He’s been at Renown since 2016, where he started as a phlebotomist and was encouraged to explore career advancement in the medical field. He applied to work as a technician on Renown’s Clinical Decision Unit- a short stay unit within the hospital for people who need clinical care, but do not need to be admitted to the hospital. Luis worked with patients and clinicians in the Clinical Decision Unit for a year before requesting to work in Renown’s innovative Alternate Care Site, built for patients recovering from COVID-19, for additional care before they returned home. Luis was scheduled to take the Medical College Admission Test® in April of this year to fulfill his dreams of becoming a doctor, but the COVID-19 pandemic forced him to change his plans. He plans to reschedule his medical school admission exam in February. He is excited to begin his training, possibly at UNR School of Medicine, and hopes one day to be a physician caring competently and compassionately for those in need.  Luis has so much to look forward to, after such a difficult year. Luis turned 33 in October, and on his birthday, contracted COVID-19 after attending a family party. He experienced fever and noticed how dramatically the COVID-19 virus affected his breathing, his lungs, and his energy level. After spending time at home recovering, Luis recovered, tested negative, and returned to work. As a result of his experience and his interest in medicine, Luis has done a lot of research on the vaccine.  Luis is bilingual and volunteers with CARE Chest of Sierra Nevada, a non-profit organization that provides free medical equipment, supplies, and prescription assistance to underserved populations when he is not working at Renown.  Vaccine one more tool to help fight pandemic “The best protection from COVID-19 will be a combination of getting a COVID-19 vaccine, wearing a mask, staying at least 6 feet away from others, avoiding crowds, and washing your hands often,” says Amy McCombs, MSN, RN, CCRN, CNML, vice president of Quality for Acute Services for Renown, and the champion of the vaccination effort for Renown. “No one tool alone will stop this pandemic, it will take a combination of all of us using all of these efforts to fight the spread of this virus. Though there has been positive news about vaccine development, no one knows when those vaccines will be ready for widespread use. In the meantime, everyone must remain vigilant, take precautions and follow public health orders.”  “This vaccination is a game-changer in terms of improving the health of our community,” said Paul Sierzenski, MD, MSHQS, Chief Medical Officer, Acute Services, Renown Health. "Given the demands of this COVID-19 pandemic, we are pleased to be able to provide this vaccination to help in the fight. We will follow CDC recommendations for a tiered approach to vaccine distribution. Our goal is that by spring, all Renown physicians; employees and their family members; and all Hometown Health members and Renown patients interested in receiving the vaccine will have an opportunity to be vaccinated.” The COVID-19 vaccine is not mandatory for all Renown employees, but is strongly advised. Renown is covering all costs of the vaccine, and it is being offered free of charge to employees. Register for Renown Epic MyChart now. To streamline the notification, consent, scheduling and reminder process for vaccine distribution, as well as to post to Web IZ Nevada’s Statewide Immunization Information System, all who are interested in receiving the vaccine through Renown will need to enroll and obtain an Epic MyChart account.  Stay Up-to-date on COVID-19 Renown Health is prepared to safely screen, diagnose and care for patients with respiratory illness, including COVID-19. To stay up-to-date on communications regarding Renown’s distribution of the COVID19 vaccine, FAQs and the scientific evidence behind the vaccine, visit https://covid.renown.org/ Join the Renown team Renown Health remains committed to hiring key roles in our organization to support the health and well-being of our community. To join the Renown family to Fight the Good Fight, apply on line at https://careers.renown.org/ Support the Renown team Renown Health, a charitable, not-for-profit organization, is so grateful for our community’s support during these unprecedented times. To donate to Renown patients or providers, visit https://www.renown.org/donations-covid-19/.   About Renown Health Renown Health is a locally governed and locally owned, not-for-profit integrated healthcare network serving northern Nevada, Lake Tahoe and northeast California. Renown is one of the region’s largest private employers with a workforce of more than 7,000. It comprises three acute care hospitals, a rehabilitation hospital, the area’s most comprehensive medical group and urgent care network, and the region’s largest and only locally owned not-for-profit insurance company, Hometown Health. Renown has a long tradition and commitment to continually improve the care and the health of our community. For more information, visit renown.org. About the Washoe County Health District The Washoe County Health District has jurisdiction over all public health matters in Reno, Sparks, and Washoe County through the policy-making Washoe County District Board of Health. The District consists of five divisions: Administrative Health Services, Air Quality Management, Community and Clinical Health Services, Environmental Health Services and Epidemiology & Public Health Preparedness. More info can be found here.

    Read More About First COVID-19 Vaccines Administered to Physicians Today

    • Tuesday, Dec 15, 2020

    Renown Institute Expands Partnership to Offer ELF Testing

    Together, will test over 30,000 qualifying study participants by 2023 for risk of cirrhosis and liver-related illnesses. Renown Institute for Health Innovation (IHI) announced today that the organization and Gilead Sciences, Inc. will be joining forces with Siemens Healthineers to offer the Enhanced Liver Fibrosis (ELF™) Test to people with risks for nonalcoholic steatohepatitis (NASH) enrolled in the Healthy Nevada Project (HNP). The ELF Test will help identify people most at risk for progressing to cirrhosis and liver-related outcomes and allow healthcare providers to intervene before irreparable damage occurs. This noninvasive blood test uses three serum biomarkers to create an ELF score from a predefined algorithm, which can be used by doctors to help evaluate if a patient requires increased medical care and monitoring for their condition. Nonalcoholic fatty liver disease (NAFLD), which includes NASH, is prevalent in Nevada and under-diagnosed, likely affecting more than 500,000 adult Nevadans. If undetected and untreated, NASH can result in liver cirrhosis and may require liver transplantation or lead to death. There are more than 12,000 people on a waitlist for liver transplantation in the U.S. and this number continues to rise due to the increasing prevalence of NAFLD. “Thanks to important data collected through our Nonalcoholic Steatohepatitis Liver Disease Genome Atlas study, we now know that NASH is prevalent in the state of Nevada,” said Tony Slonim, M.D., DrPH, FACHE, president and CEO of Renown Health. “We are proud to expand our partnership with Gilead and begin working with Siemens Healthineers to improve health of those with liver disease and to take early detection one step further by offering Enhanced Liver Fibrosis, ELF testing for patients of Renown Health. This test provides our team of highly-skilled physicians an advanced, noninvasive method to actively assess dynamic liver fibrosis in study participants and intervene whenever necessary, contributing to a healthier Nevada.”  “Gilead believes that noninvasive tests, including the ELF Test, will help improve the experience of people living with NASH. These tests may help to diagnose liver disease, monitor disease progression and evaluate responses to treatment without the requirement for liver biopsy,” said Rob Myers, MD, Vice President, Liver Fibrosis Clinical Research at Gilead Sciences. “The ELF Test has proven itself to be a valuable tool in NASH management and we hope this partnership will further support its use in routine care.”  “We are very pleased that NASH patients in the Healthy Nevada Project now have access to the ELF Test which offers clinically useful prognostic information for their condition with the convenience of a simple blood test. Using our advanced laboratory expertise together with Renown IHI and Gilead, we can work towards better understanding of NASH and liver disease in a representative patient population,” said Sebastian Kronmueller, Head of Molecular Diagnostics at Siemens Healthineers. “We launched the Healthy Nevada Project to help people understand more about their health, to identify serious health risks, and to give people access to innovations like the ELF Test, so they can live their best lives,” said Renown’s chief scientific officer, Dr. Joseph Grzymski, who is also a research professor at the Desert Research Institute and principal investigator of the Healthy Nevada Project. It’s incredibly rewarding to be able to report clinical findings to help our 50,000 volunteer study participants, and to assist healthcare providers in helping their patients.” The provision of the ELF Test builds on a previously announced strategic collaboration between the Renown IHI and Gilead in July 2019. This ongoing partnership aims to collect and analyze de-identified genetic and electronic health data from 60,000 qualifying study participants to enhance the understanding of NAFLD and NASH and to potentially inform development of treatment options for these diseases.  About NAFLD and NASH NAFLD is a build-up of fat in the liver of people who do not have a history of alcohol misuse. It is normal for the liver to contain some fat, but if more than 5 percent of the liver content is fat, it’s considered a fatty liver (steatosis). NASH is the most severe form of NAFLD in which a person has liver cell damage and inflammation of the liver. Inflammation and liver cell damage can cause fibrosis, or scarring of the liver, and can cause decreased liver function (1). The symptoms of NASH are often silent or non-specific, making it difficult to diagnose. About one-third of people with NASH develop cirrhosis or irreversible liver damage (2). About the ELF™ Test The ELF Test is a noninvasive blood test that can quickly identify which patients are at an elevated risk for developing cirrhosis and other liver-related clinical events (LREs). In contrast to standard liver enzyme tests that reflect liver damage that has already occurred, the ELF Test combines three serum direct biomarkers of active fibrosis. The ELF Test algorithm measures each of these biomarkers to create an ELF score, which can be used as an aid to assess the risk for future disease progression. Doctors may use this ELF score to help evaluate if a patient requires increased medical care and monitoring for their condition. Individuals interested in determining their risk for NASH and its progression are encouraged to enroll in the Nonalcoholic Steatohepatitis Liver Disease Genome Atlas study. Those who have already consented and participated in the study will be contacted with more information on how to receive an ELF blood test. For more information or to enroll, please contact RenownIHI@renown.org or (775) 982-6914. The Enhanced Liver Fibrosis (ELF™) Test kit is not available for sale in the U.S. Product availability may vary from country to country and is subject to varying regulatory requirements.  In the U.S., the ELF Testing Service is available from Siemens Healthcare Laboratory, LLC (SHL), a CLIA-certified laboratory located in Berkeley, Calif. The ELF Testing Service, including the establishment of performance characteristics, was developed by SHL. The ELF Test has not been cleared or approved by the U.S. Food and Drug Administration. SHL is regulated under CLIA as qualified to perform high complexity testing. The ELF Test is used for clinical purposes and should not be regarded as investigational use only or research use only. About Renown Health Renown Health is the region’s largest, locally owned and governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. With a diverse workforce of more than 7,000 employees, Renown has fostered a longstanding culture of excellence, determination and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the region’s largest, locally owned not-for-profit insurance company, Hometown Health. Renown’s institute model addresses social determinants of health and includes: Child Health, Behavioral Health & Addiction, Healthy Aging and Health Innovation. Clinical institutes include: Cancer, Heart and Vascular Health, Neurosciences and Robotic Surgery. Renown is currently enrolling participants in the world’s largest community-based genetic population health study, the Healthy Nevada Project®. For more information visit, renown.org. About the Renown Institute for Health Innovation Renown Institute for Health Innovation is a collaboration between Renown Health - a locally governed and locally owned, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California; and the Desert Research Institute - a recognized world leader in investigating the effects of natural and human-induced environmental change and advancing technologies aimed at assessing a changing planet. Renown IHI research teams are focused on integrating personal healthcare and environmental data with socioeconomic determinants to help Nevada address some of its most complex environmental health problems; while simultaneously expanding the state’s access to leading-edge clinical trials and fostering new connections with biotechnology and pharmaceutical companies. Learn more at healthynv.org. Renown Health is Nevada’s most comprehensive and integrated healthcare network and maintains electronic health records for 1.02 million registered patients. In 2016, Renown Health and the Desert Research Institute established the Healthy Nevada Project (HNP), the nation’s first community-based population health study. In 2017 HNP began a partnership with Helix to leverage its population health services, Exome+™ sequencing, and consumer engagement tools. The HNP is now an ongoing collaboration between Renown IHI, the Desert Research Institute, a global leader in environmental data and applied research, and Helix, a personal genomics company. HNP combines genetic, environmental, social and clinical data to address individual and community health needs with the goal of improving health across the state and the nation. The HNP currently has over 60,000 participants. For more information, visit healthynv.org.  About Siemens Healthineers Siemens Healthineers AG (listed in Frankfurt, Germany: SHL) is shaping the future of Healthcare. As a leading medical technology company headquartered in Erlangen, Germany, Siemens Healthineers enables healthcare providers worldwide through its regional companies to increase value by empowering them on their journey towards expanding precision medicine, transforming care delivery, improving the patient experience, and digitalizing healthcare. Siemens Healthineers is continuously developing its product and service portfolio, with AI-supported applications and digital offerings that play an increasingly important role in the next generation of medical technology. These new applications will enhance the company’s foundation in in-vitro diagnostic, image-guided therapy, and in-vivo diagnostics. Siemens Healthineers also provides a range of services and solutions to enhance healthcare providers ability to provide high-quality, efficient care to patients. In fiscal 2020, which ended on September 30, 2020, Siemens Healthineers, which has approximately 54,000 employees worldwide, generated revenue of €14.5 billion and adjusted EBIT of €2.2 billion. Further information is available at www.siemens-healthineers.com.Media Contact for Siemens Healthineers: Lance LongwellM: 610-448-6341E: lance.longwell@siemens-healthineers.com

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