ARTIFICIAL INTELLIGENCE IN MEDICINE CAN IMPROVE OUTCOMES

Algorithmic Medicine Brings

AI Tools to the Bedside

By Becky Gillette

There are many skills in medicine that a machine can’t replicate. Skills like how to listen to a patient and ask questions that go beyond what their current medical issue might be, how to empathize and develop trust, and many technical skills that are not currently able to be performed by a machine. For other skills like repetitive analysi and knowledge retrieval and routine, the average clinician can be greatly helped by an artificial intelligence (AI) field known as algorithmic medicine, said Joseph Sanford, MD, director of the University of Arkansas for Medical Sciences (UAMS) Institute for Digital Health & Innovation (IDHI).

“Algorithmic medicine brings these analysis and interpretation tools to the bedside, so that clinicians do not have to seek it out,” Sanford said. “It can improve accuracy in diagnosing from medical images. It can nudge clinicians towards care options that the literature supports, or away from those that have been found to be less effective. At its best, algorithmic medicine standardizes and improves a practitioner’s decision making. It does not supplant it.”

The goal is to improve medical decision making by leveraging the vast amounts of data in the electronic medical record with techniques from behavioral economics.

“There is excellent work being done in personalized genomics, medical imaging, population health modeling and health care logistics, among others,” Sanford said. “This is a rapidly evolving field, and I think the most impressive results are ahead of us.”

Trust is an incredibly important issue in medical decision making generallym, and Sanford said it can be difficult to get patients to trust these new tools. He said it is crucial to educate patients that these tools are just that, tools.

“They are not making decisions for the clinician, nor can they ever override patient autonomy,” Sanford said. “While not precisely the same, think about using these tools in the same way you might use Maps to plan a trip. It provides more information than you could ever collect on your own about route, duration, recommended stops, traffic conditions, etc. But only you can choose which road you drive down.”

Sanford said that factors that influence trust in AI are the same that influence trust in any large, complicated system: transparency, efficacy, control, perceived credibility and ethical alignment with your culture are just a few of the factors that must be considered.

Providers use algorithms for patient care every day already, said UAMS Associate Chief Medical

Informatics Officer for Innovation, Research, and Entrepreneurship Kevin Sexton. “We use them to adjust dosages of medications, evaluate patient risk for a particular condition, among other uses,” he said. “The difference here is that the computer is helping make decisions. “

He finds it interesting that we trust AI in many parts of our lives every day, from what movies we watch, songs we listen to, to where we go to dinner. It’s easier for AI to gain adoption with decisions that have little downside risk.

“It’s this risk and low tolerance for error that also inhibit trust in these systems for clinical decisions,” Sexton said. “That’s why we see the most successful implementations where machines work with the clinicians to make a decision as a partner.”

The other potential is to expand screening capabilities of the health care system. Sexton said there is great work being done with AI for eye exams to detect the changes of illnesses like diabetes and hypertension.

“These types of exams are difficult to train providers to do consistently, but a machine taking pictures for analysis does a very consistent job obtaining this information,” Sexton said. “Also, with more patients wearing monitors at home (anything from a smart watch to a medical device) there is tremendous data for analysis, and health care systems don’t currently have a universal, organized approach to analysis of all of these data streams. Machines are ideal for this use case as well. Ultimately, we think that the future of machines in health care should be to allow more access to care.”

Both doctors said getting clinical trust in an AI system is much the same as it is for patients.

“We share the same biases and concerns about providing good care that patients have about receiving it,” they said. “Some aspects are of more interest to the provider than the patient. Namely, a clinician generally wants to see that it is im- mediately effective on a variety of patients. They also should have a strong understanding of what’s going on underneath the hood, particularly focusing on where the system is weak, so they can be prepared to independently validate something that appears odd to them. And they must have a strong sense of control as the care of the patient is ultimately their responsibility.”

Health care finances were difficult prior to the pandemic and have not gotten easier since. The UAMS physicians say that algorithmic medicine solutions need to demonstrate added value to clinicians and health care systems for whom any additional expense might mean decreasing care at the bedside.

Where investment has already been made, in the electronic medical record, for example, they are seeing results in medical and research data that would have previously been impossible to analyze. Further out, they hope to see augmented decision making act as a force multiplier, enabling physicians and nurses to care for more patients in the same time span and at a higher average quality that they would have without these tools.

AcreTrader

AcreTrader was established in 2018, and its online investor platform launched in 2019. The Fayetteville-based farmland investing company allows individuals to participate in farmland ownership through a first-of-its-kind portal. Farmland is a historically attractive asset, with low volatility and strong returns, but barriers to entry (price, the logistics of farm management) make it inaccessible to many investors. AcreTrader aims to make the process of buying and selling land common, transparent and easy by leveraging technology, data and the expertise of its team. The process also bridges a gap between farmers and investors, giving the former an innovative route to capital and the latter a way to invest directly in farmland and support the agricultural industry. Using proprietary software and processes, AcreTrader identifies farmland and subjects each parcel to a rigorous review before deciding whether it should become an offering on the website. AcreTrader takes care of the ongoing management and administration for each farm acquired; the company manages farms across the country, with crops including soybeans, corn, wheat, peanuts, cotton, potatoes, onions, beets and timberland.

Apptegy

Little Rock education technology startup Apptegy was born out of the need for a centralized tool to share information between schools and families. The company’s solution, Thrillshare, is a communication platform school leaders can use to distribute news, stories and media through a variety of channels. Apptegy allows schools to build a strong digital identity with custom-built applications and websites that make it easy for parents, teachers, students and administrators to send and receive the information they need. From lunch menus to text alerts to student success stories, Apptegy makes sharing simple for everyone involved. Since its launch in 2015, the company has grown to 400 employees, working with nearly 3,000 school districts across all 50 states and even internationally. Apptegy was named one of America’s Best Startup Employers by Forbes in 2020 and 2021. Apptegy was also awarded a spot on Inc. 5000’s list of the fastest growing private companies in 2021.

Acxiom Corp.

Headquartered in Conway, customer intelligence company Acxiom operates across the United States and around the world. For over 50 years, Acxiom has enabled people-based marketing for its clients with data solutions and systems that improve customer experience and business performance, all while prioritizing responsible data use. Working with clients across industries from financial services to retail, from food delivery to health care, the company offers a full suite of strategy consulting, predictive and marketing analytics and marketing measurement offerings. Acxiom’s Real Identity™ solution was named “Best Overall MarTech Solution” in the 2020 MarTech Breakthrough Awards program. Real Identity™ synthesizes and analyzes billions of interactions to help brands better recognize their audience and build deeper customer relationships. As the digital and offline worlds of customer interaction evolve, Acxiom also commissions research to forecast trends and keep clients abreast of the shifting marketing landscape.

Bold Strategies

Rogers-based eCommerce company Bold Strategies helps brands grow faster both before and after launch using proven market assessment, optimization and growth capabilities. In 2017, the company launched the first ever end-to-end eCommerce agency to bring together Pure Play, Omni and Direct-to-Consumer (DTC) selling. Bold Strategies helps brands test market their products online before jumping into a full-scale national launch. The company’s Digital Test Markets and proprietary OptiBrain™ software provide Size of the Prize and detailed optimization suggestions. In addition to full-scale test markets, Bold Labs also features an expert conversion rate optimization (CRO) team that can help brands fine-tune their website or retail messaging, imagery, claims and user experience. From research to launch and all the steps in between, Bold Strategies aims to give brands the tools and expertise they need to achieve growth across an array of eRetailers.

Field Agent

Headquartered in Fayetteville and launched in 2010, Field Agent’s innovative application crowdsources shoppers’ smartphones around the world to provide insights, product reviews, ondemand sales and more. With over 2 million app users, or agents, brands, retailers and agencies, can collect the in-store information they need to make informed business decisions. Field Agent’s solutions are designed by retail professionals and come in a range of self-serve and full-service options. Field Agent has pioneered dozens of fast, simple, self-serve products, including auditing, marketing and research, that can be shopped, purchased and launched in just a few minutes. Pre-built for cost and speed, the click-and-launch products are available on the company’s Plum retail-solutions marketplace. Field Agent also offers custom-tailored solutions to meet specific brand needs. The company’s clients represent a wide variety of industries and products, including Coca-Cola, Clorox, Gillette, 3M, General Mills, Little Caesars, Tyson and Halo Top.

Gainwell Technologies

Gainwell Technologies is a Conwaybased provider of cloud technology solutions vital to the administration and operations of health and human services programs. Gainwell has over five decades of industry expertise, offering an array of scalable and flexible solutions to clients in 50 states and territories nationwide. Gainwell’s CMS-certified Medicaid Management solutions are modular, intelligent and cloud-based, with a comprehensive and integrated suite of solutions that help accelerate claims processing, support value-based care and control escalating costs. Gainwell’s Coordination of Benefits solutions for Medicaid, Medicare, Military and State Agency programs use proprietary data and algorithms, and the company’s Program Integrity solutions root out erroneous claims at any stage in the claim cycle. The company also offers human services and public health, pharmacy, systems integration and analytics solutions to help agencies operate more efficiently and effectively for the wellbeing of their communities.

NOWDiagnostics

NOWDiagnostics is a diagnostics testing manufacturer working to develop rapid, accurate, affordable and easy-toadminister over-the-counter and pointof-care tests. Founded in 2013 and headquartered in Springdale, the company has produced 320,000 tests across 10 countries and 14 distributors. The company’s ADEXUSDx® product line uses a single drop of blood to test for a variety of common conditions, illnesses and diseases and provides results in a matter of minutes. By eliminating the need to send tests to off-site laboratories, NOWDiagnostics can decrease the results waiting period by days. The company currently offers an hCG (pregnancy) test in the United States and Europe, as well as two heart attack tests and three toxicology tests in Europe. Additional tests are in the development pipeline, including sexually transmitted diseases, food intolerances, common infectious diseases and a variety of screening tests.

RevUnit

Founded in 2012, Bentonville’s RevUnit is a technology studio that helps supply chain clients identify and implement data solutions that actually prove ROI. RevUnit specializes in software products that help increase productivity, learning, communication and engagement in the workplace. RevUnit works with clients across industries, including transportation, freight, logistics, retail and manufacturing, to achieve results through innovative data solutions. RevUnit’s solutions include rapid prototypes, strategy workshops, UX audits and more to help clients take effective action quickly. Within a year of its founding, the company became one of Walmart’s key strategic technology partners; in the decade since, RevUnit has created technology and data solutions for several Fortune 500 companies. RevUnit has been named to the Inc. 5000 list of fastestgrowing private companies, as well as the Entrepreneur 360 list of America’s most innovative businesses.

Teslar Software

Teslar Software operates out of Springdale and is composed of bankers and engineers helping to improve efficiency at regional financial institutions across the country. The company began as 3E Software in 2008; Teslar was born soon after and has grown year after year ever since. The company’s eponymous software is a SaaS solution designed to save time, improve the accuracy of data and make information more accessible regardless of institution size. The company has evolved into a vital strategic partner for its clients, responding to their needs with a comprehensive suite of modules to improve every aspect of modern banking. Through a scalable, streamlined process that integrates multiple systems and empowers bankers, Teslar Software allows community banks to keep up with competition even as regulations change. Among others, Teslar Software’s clients include Centennial Bank, Simmons Bank and Citizens Bank.

ZenWork

Founded in 2011 as Tech Atlantis, Fayetteville-based ZenWork is a fast-growing digital tax compliance and regulatory reporting company. All of the company’s products are IRSapproved and come with bank-grade security measures. ZenWork’s array of products include its Tax1099 e-filing service, Compliancely background and identity check tool, SQUAHR human resources software, other IRS form and e-filing solutions and Fidentity, an application designed to help offices manage visitors, events, employees and other processes. The company currently serves over 100,000 customers nationwide, including 30,000 CPA firms, as well as enterprise customers including Allbirds, Berkshire Hathaway, GrowthForce, Rover and Deloitte. ZenWork stays up to date on federal and state compliance requirements to make the filing process for clients as simple as possible. In 2021, the company received $162.5 million in minority investment from Boston firm Spectrum Equity, amounting to nearly twice as much of the venture capital invested in Arkansas companies during the first nine months of that year.

Joe Ehrhardt is the CEO and founder of Teslar Software, a provider of lending process automation tools for community financial institutions.

In his role, Ehrhardt shapes the company’s strategic vision, oversees team and company culture and ensures team members have access to the resources they need to effectively serve Teslar’s client base.

Ehrhardt entered the banking industry in 1999 as a teller at Arvest Bank before moving into the role of software development manager with ANB Financial.

Inspired by the impact community institutions have on local consumers and small businesses, Ehrhardt launched Teslar (formerly 3E Software) in 2008 to empower community bankers with tools they need to grow with efficiency and confidence.

Ehrhardt completed both his bachelor’s degree in computer engineering and his master’s degree in information systems at the University of Arkansas at Fayetteville.

Humeyra Ulusoy Erol Chief Technology Officer CatalyzeH20

As chief technology officer at CatalyzeH2O, Humeyra Ulusoy Erol, PhD is responsible for product design, the research and development of electrochemical techniques and solving technical challenges for the removal of contaminants from wastewater.

Erol received her doctorate degree in chemical engineering at the University of Arkansas at Fayetteville, where she collaborated with industry partners and sponsors to solve industry-related water treatment problems as part of the MAST center.

Before her role as CTO, Erol was the company’s senior research and development engineer.

In 2022, CatalyzeH2O came in third place at the Northwest Arkansas Tech Summit’s pitch competition for its advanced filterless electrochemical dualstage water purification system.

Jeston George is the CEO and founder of Apptegy, a Little Rock-based education technology company that has been recognized as one of the country’s fastest-growing startups in the ed-tech sector.

The company’s Thrillshare software allows schools to enter news, stories and other forms of media into a single platform which distributes the information to linked tools such as social media, SMS, voice calls and websites.

Since its founding in 2015, Apptegy has grown to over 400 full-time employees across multiple offices and works with over 3,500 school districts across the United States.

In the spring of 2017, after receiving several rounds of in-state investment, Apptegy announced an investment round of $5.7 million from Kansas Citybased Five Elms Capital.

George has been a serial entrepreneur throughout his career, founding and successfully exiting two companies before starting Apptegy.

Kenny Kinley President/CEO Edafio

When Kenny Kinley joined Edafio in 2011, he brought decades of leadership experience in international data and technology services. Still, he knew there was something special about this Arkansas-based, locally focused IT services provider— Edafio had a reputation for delivering highly professional technology expertise with a personal touch and community orientation. Becoming President/CEO of Edafio in 2020, Kinley was determined to build on this foundation and stay in touch with the communities Edafio’s clients serve, to expand while preserving Edafio’s core values. Under Kinley’s leadership, Edafio has grown to be Arkansas’s largest technology solutions provider and one of the nation’s top-ranked MSPs. Offering end-to-end IT consulting and managed services, cybersecurity and more, Kinley still sees Edafio’s impact on businesses in the local communities as the most meaningful source of differentiation. Edafio sets a rare example in the industry by putting people and communities first. Kenny graduated from the University of Central Arkansas in 1995.

Malloy Founder/CEO AcreTrader

Carter Malloy is the founder and CEO of AcreTrader, an online platform designed to increase investor access to farmland.

Growing up in an Arkansas farming family, Malloy has had a lifelong passion for investing, agriculture and conservation; since launching AcreTrader in 2019, he has led the company to exponential growth.

The company has successfully raised over $60 million in Series B funding and grown from 20 employees to 120 employees across its two business divisions, which include AcreTrader and Acres, a comprehensive land analysis and mapping tool.

AcreTrader has been featured in The New York Times, Bloomberg and Barron’s, in addition to being named one of 13 Financial Fintechs to Watch by Business Insider.

Prior to founding AcreTrader, Malloy was part of an equity investment firm and a managing director with Stephens, Inc.

Charles Morgan CEO First Orion

Charles Morgan is the chairman and CEO of First Orion. Morgan has always loved gadgets and machinery and earned a degree in mechanical engineering from the University of Arkansas in 1966.

After working for several years as an IBM systems engineer, Morgan joined a small company in Conway with 25 employees in 1972. Under Morgan’s leadership, that company grew into Acxiom, a world leader in customer data management with 7000 employees globally and $1.5 billion in revenue. For his achievements, he was inducted into the Arkansas Business Hall of Fame in 2004.

Morgan left Acxiom in 2008 to found First Orion, which is now a global provider of digital call experiences for the world’s leading carriers, enterprises and developers. In 2015 he published a chronicle of his life entitled “Matters of Life and Data.” He lives in Little Rock with his wife, Susie.

Director of UAMS Institute for Digital Health & Innovation/ Co-director Div. of Innovation University of Arkansas for Medical Sciences

Joseph Sanford, M.D., is director of the University of Arkansas for Medical Sciences Institute for Digital Health & Innovation, where he co-directs its Division of Innovation.

He is chief clinical informatics officer for UAMS and an associate professor in the Department of Anesthesiology in the UAMS College of Medicine. He also is the UAMS fellowship site director for the clinical informatics fellowship based at UAMS and Arkansas Children’s. Sanford has been on the forefront of digital health and clinical informatics initiatives in recent years, succeeding the Institute’s founding director Curtis Lowery, MD, in 2020. Sanford’s expertise has been applied in digital health initiatives relating to the COVID-19 pandemic as well as the development of the statewide UAMS Health system. Sanford’s clinical background is in general anesthesiology with fellowship training in management of perioperative services from Stanford University. He holds a Bachelor of Science degree in computer science from the University of Arkansas at Fayetteville.

President BioVentures LLC.

Kevin Sexton, M.D., is president of BioVentures LLC, the technology licensing office and business incubator based at the University of Arkansas for Medical Sciences.

Sexton, a trauma surgeon and associate professor in the UAMS College of Medicine’s Department of Surgery, became interim director in 2021 following the death of Nancy Gray, Ph.D., who had led BioVentures since 2015. BioVentures helps equip researchers with technology licensing, patent protection and other resources that are required for company startups.Sexton also is co-director of the Health Sciences Innovation and Entrepreneurship (HSIE) Training Program for UAMS postdoctoral fellows, a program of the Translational Research Institute. He is an associate director of the UAMS Institute for Digital Health & Innovation and associate chief clinical informatics officer for Innovation, Research and Entrepreneurship. Board certified in clinical informatics, much of Sexton’s work has been investigating new software systems for UAMS, analyzing how best to integrate systems and examining how the electronic health record can be used for research.

Founder/CEO Ox

Charu Thomas is the Founder and CEO of Ox. Ox provides human centered automation technology for retail and supply chain operations. In March 2021, Ox announced a $3.5 million seed round in funding from MaC Venture Capital based in Los Angeles, California. Today, Ox has over 30 employees and provides operational infrastructure for some of the largest enterprises in the world. Prior to Ox, Charu was an internationally awardwinning wearable computing researcher from Georgia Tech’s No. 1 ranked industrial engineering program. She was also the youngest member of the Forbes 30 under 30 Manufacturing and Industry list in 2020. Outside of work, Charu enjoys exploring meditation, math and metaphysics.

University of Arkansas

As the largest university in the state, the University of Arkansas has programs and courses to teach students about almost any kind of technology imaginable. Simply teaching what is already known is not enough, however, which is why the U of A is also a nationally recognized hub for research that pushes the boundaries of modern technology.

Research centers at the U of A include the Institute for Nanoscience and Engineering, the Arkansas High Performance Computing Center, the Center for Advanced Spatial Technologies and the High Density Electronics Center.

The U of A is also eager to share the fruits of its research through the Arkansas Research and Technology Park, which partners with technology-intensive companies and allows them to make use of the university’s resources. Closely connected to this is the GENESIS Technology Incubator, a business incubator that partners with tech-focused entrepreneurs during the critical early stages of a company.

University of Arkansas Community College at Morrilton (UACCM)

There are countless exciting advances in the world of software development, but what about the hardware that makes the software possible? Infrastructure and machinery may not be glamorous, but without them the rest of our tech-based world would grind to a halt.

At the University of Arkansas Community College at Morrilton, students will find courses on coding, cybersecurity and the use of work-related programs. UACCM’s Workforce Training Center offers non-credit educational and training programs to produce knowledgeable and capable employees.

These programs include courses on things like fiber optics and broadband as well as training courses to use the type of heavy machinery needed to build that infrastructure such as underground directional drills.

Arkansas Center for Data Sciences

The Arkansas Center for Data Sciences is a nonprofit organization dedicated to growing and improving Arkansas’ IT pipeline by working with individuals, employers, institutions and community partnerships.

For the individual career seeker, ACDS offers training resources and apprenticeship programs with real IT employers; these programs often end in a job offer. For employers, these apprenticeships not only help with locating and training IT talent but can potentially include state tax credits.

The ACDS also assists higher-learning institutions with IT and data science programs and hosts a variety of meetings and events to promote learning throughout the community. These include networking events, seminars, “Lunch & Learns” and webinars.

Arkansas Biosciences Institute

The Arkansas Biosciences Institute is a consortium of five major research institutions: Arkansas Children’s Hospital; Arkansas State University; the University of Arkansas Division of Agriculture; the University of Arkansas, Fayetteville; and the University of Arkansas for Medical Sciences.

Established by referendum in 2000 to research tobacco and smoking related illnesses, it has expanded into many new biological and medical fields. Though the ABI’s primary objective is research rather than education, it does provide undergraduate and graduate students with an incredible chance to participate in projects that improve the health of our state through research and technology.

For K-12 students, the ABI’s outreach program offers school group tours of ASU laboratories and a transgenic plant facility to expose students to biotechnology research focused on agriculture, medicine and health.

University of Central Arkansas

The University of Central Arkansas has taken major strides to promote technological education and advancement for the state. One such stride was the establishment of the Arkansas Coding Academy, which offers a coding bootcamp for quick skill building as well as a more robust 26-week software development program that will include a cybersecurity bootcamp.

UCA’s cyber range is a high-tech closed network which can be used as a cybersecurity training space. As an isolated and controlled environment, the Cyber Range can simulate any kind of cyber-attack and give students real-world experience in defending against them.

Through a partnership with Startup Junkie, UCA also established the Conductor, which provides accelerators, resources and other events to help develop tech-enabled startups, many of which are behind some of the biggest technological advancements in our state.

University of Arkansas for Medical Sciences

The University of Arkansas for Medical Sciences is at the cutting edge of medical technology in both the state and nation and has been home to treatments more advanced than anywhere else in the world.

As well as being the state’s only health sciences university, UAMS possesses numerous “core facilities” that outside investigators can make use of to perform research with resources that are not available elsewhere. These include specialized facilities for brain imaging research, digital microscopy, experimental radiation, molecular imaging, flow cytometry and more.

UAMS facilities and expertise have resulted in grants from numerous organizations on the state and federal levels such as the Department of Defense, which is currently funding research on dozens of topics such as combat casualty care, traumatic brain injuries, the health effects of radiation and neurotoxin treatment.