Bobs Evolution 4 Cnc

[Ellington Walford]

BobsCNCis what happens when two old friends, one with a background in mechanical engineering and a long history of building CNC machines and the other with a career in sales and marketing, join forces along with their wives and family. What began in a garage shop in 2015 rapidly grew into a thriving enterprise that is revolutionizing the way CNC machines are made.

I do not profess to be an expert in the ongoing debate between creationism and evolution. The prevalent arguments in both educational and theological spheres often seem trivial. Maybe I am a simpleton, but I have three primary reasons that I believe in the creation narrative in the book of Genesis.

First, the concept of a creator just makes sense. If you attend an elaborate Kentucky Derby party and see a spectacular ice sculpture of a horse, would you wonder how it was crafted? Would you consider whether the artist may have purchased several bags of ice at the store, poured them in a cooler, and, during their commute, hit a large pothole that caused the ice to bind together, forming a marvelous, perfect depiction of a horse? Of course not. You would compliment the artist on their craftsmanship.

The Arkansas Health Network (AHN) is the first clinically integrated network to achieve dual URAC accreditations for clinical integration and employer-based population health. Bob Sarkar, M.B.A., who has been president and CEO of AHN since 2015, recently spoke with Healthcare Innovation about the evolution and growth of the network and its participation in value-based care models.

Sarkar: I joined Arkansas Health Network in 2015 when it was in its infancy stage. I was the first full-time employee, so you could say that it's kind of my baby. Today we have close to 50 employees.

At the time I joined, we were managing a Medicare Shared Savings ACO and had just done one year with a network of close to 1,100 providers. We were managing close to 40,000 value-based care lives. We were predominantly a Central Arkansas-focused network. Today we are Arkansas' largest provider-led clinically integrated network. We are a subsidiary of CommonSpirit Health, which is the largest nonprofit parochial health system in the country, operating in 24 states.

Innovaccer helps us do proactive care to head off claims and as a result see efficiencies. In our URAC journey, one of the key components was what kind of technology we have. How are we integrating new EMR data? How are we integrating claims data? Innovaccer comes into play because we have 35 EMRs that could be integrating into our presence in the state. Innovaccer plays a vital role in helping our population health management team to identify proactively who is already high risk and who could be rising risk to intervene proactively.

Sarkar: Initially we were taking upside risk; then with maturity we started taking upside and downside risk. And now we are in an enhanced pathway taking the highest level of risk, 75 percent upside risk, 40 percent downside risk. For the last five years, we have been saving a significant amount of money for CMS, and we have been blessed to have received shared savings from CMS. Patient attribution is a major challenge and getting clean data from CMS at the right time is a challenge that continues. A couple of large health systems and providers are joining us to be part of our MSSP ACO. But we have been diligent to ensure that their performances do not dilute ours. So our assessments and our litmus tests, so to speak, for incorporating them are very high.

Sarkar: What we have seen is a lot of increase in the need for behavioral healthcare. We are putting appropriate strategic resources in place, whether it is addiction centers or other outpatient resources and integrated behavioral health and primary care. We are seeing behavioral health issues becoming more acute. Plus, there was a shortage of behavioral providers already. It was a chronic issue already in the industry and it has been aggravated quite a bit. We are all trying to focus our energy into that area.

About Artem Kaznatcheev

From the Department of Computer Science at Oxford University and Department of Translational Hematology & Oncology Research at Cleveland Clinic, I marvel at the world through algorithmic lenses. My mind is drawn to evolutionary dynamics, theoretical computer science, mathematical oncology, computational learning theory, and philosophy of science. Previously I was at the Department of Integrated Mathematical Oncology at Moffitt Cancer Center, and the School of Computer Science and Department of Psychology at McGill University. In a past life, I worried about quantum queries at the Institute for Quantum Computing and Department of Combinatorics & Optimization at University of Waterloo and as a visitor to the Centre for Quantum Technologies at National University of Singapore. Meander with me on Google+ and Twitter.

With great sadness, we announce the passing of Bob Wayne, Distinguished Professor of Ecology and Evolutionary Biology (EEB) at the University of California, Los Angeles. Bob was a renowned, internationally recognized scientist and esteemed member of the academic community, and his contributions to the field of genetics and UCLA will not be forgotten.

Bob began his faculty career at UCLA as an Assistant Professor in 1992, after serving as the Head of Conservation Genetics, Zoological Society of London. He rose through the ranks at UCLA, becoming full Professor in 1998 and Distinguished Professor in 2019. He has published over 300 papers throughout his career in top scientific journals.

Bob was especially known for his work in the conservation genetics of wild canids, which included species such as wolves, foxes, and coyotes. He was a pioneer in using DNA technology to study these groups, and his research shed light on the genetic basis of their behavior and evolution. His work also significantly impacted the conservation and management of canid species around the globe. Locally, his work on the effects of urbanization on carnivores in Los Angeles has received considerable media attention. In a 2006 study, using genetic data, Bob and his students showed that freeways are a barrier to migration of bobcats and coyotes, establishing the premise of wildlife tunnels to allow animal crossings.

In addition to his work on wild canids, Bob contributed significantly to our understanding of the origins of domestic dogs. His groundbreaking research using genomics helped shed light on their evolutionary history, and his findings have greatly impacted our understanding of the process of domestication.

Perhaps most impressively, Bob has repeatedly reinvented himself scientifically over the last 30 years. While his research focused on applying the latest molecular techniques to studying natural populations, often those of conservation concern, his specific questions and molecular techniques changed over time. Bob pushed the boundaries technologically and conceptually with his research, paying dividends in revealing new insights. His co-authored book, published in 1996, entitled Molecular Genetic Approaches in Conservation, based on an AAAS symposium, brought together dozens of researchers using diverse methods, was one of the first of its kind, and helped to build the foundation for modern molecular conservation genetics.

Over the last few years, Bob also reinvented himself as an educator. Moving beyond lecture-based classroom presentations, Bob developed a new framework to entice freshman Life Sciences majors at UCLA into biology and research. Specifically, his new course brought students into the field at UC Reserve sites, where they would sample DNA from the environment and document their observations in online notebooks. DNA would be analyzed from these sampling sites and students gained an appreciation for biodiversity and the research process. Bob taught hundreds of students in this course. His innovative pedagogical approach was recognized by the Howard Hughes Medical Institute (HHMI) in 2018 when he received an HHMI Professor award with UCSC professor Beth Shapiro.

Bob contributed to EEB at UCLA in a myriad of ways. He served on many important faculty search committees, including committees aimed at increasing the quantitative biology in the Life Sciences Division at UCLA. He was also the first to bring the field of conservation genetics to EEB, where his laboratory was always a central hub for innovation for decades. But, perhaps his most significant contribution to UCLA was making everyone around him think bigger and bolder, moving us outside of what we found comfortable. He made us believe in ourselves, our work, and our mission. He is a leading example of a life in academic science well-lived, a touchstone for all of us. While Bob took his research and teaching seriously, he did not take himself as seriously. His dry sense of humor will be missed by his many colleagues and collaborators, especially by these authors.

Outside of UCLA, Bob was an avid biker, naturalist, and active member of the conservation community, helping to promote the conservation of wolves and protect the habitat and species in the Santa Monica Mountains he loved and where he lived and shared with his beloved wife and friend UCLA Distinguished Professor and renowned paleontologist Blaire Van Valkenburgh.

Bob will be deeply missed by his colleagues, students, and friends. His contributions to the fields of evolution and conservation genetics will not be forgotten, and his legacy will live on through the many lives he touched.

Bob is a best-selling author and scholar in the area of evolutionary psychology (as well as a podcaster: check out bloggingheads.tv). His past books like Nonzero and The Moral Animal lay down foundations for talking about the evolutionary reasons why we feel ourselves to have the sense of self, emotions, moral sentiments, and purposes that we do. Now, he applies that insight to explicating the human condition as Western Buddhism (meaning Buddhism without supernatural elements; see also our interview with Owen Flanagan) describes it: We are fundamentally deluded in a number of ways, and Bob thinks that meditative practice can help us see the world more truly, discarding some of what makes us suffer.

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