Four national centers first. Evidence before revenue. Then a launch.

The proposed role: Director, Radiation Oncology Market Development, North America. It opens radiation oncology as a new market for Epione, separate from NeuWave, starting with four centers where I have contacts today. Here is what it would own, how it builds the clinical case, and how leadership would know within a year whether it is working.

What the role owns, and what it doesn't.

Owns

Radiation oncology as a new market for Epione: a new department and buyer, with no NeuWave overlap
A four center radiation oncology advisory board, run with medical affairs under fair market value contracts
The clinical input for an expanded Epione indication, with regulatory and R&D
Launch readiness: sizing, messaging and the first customers, ready for the day the label allows

Works with

Medical affairs and clinical research, who own contracts and studies
Regulatory and R&D on the indication and the product
Epione sales and clinical specialists in accounts they already serve

Does not

Sell NeuWave or work the ablation accounts the NeuWave team already covers
Promote anything outside the cleared label
Claim outcomes the evidence does not support

Reports to: Commercial leadership. I would propose the Chief Commercial Officer.
Coverage: North America: four national centers first, then the US, then Canada.
Why now: Robots with broader CT clearances could reach radiation oncology first. One person, with a go or no go at month 12.

Each phase earned by the last.

Months 0 to 6: four centers

Ohio State, Vanderbilt, Stanford and MD Anderson engaged
Advisory board seated through medical affairs
Workflows mapped for fiducials, interstitial HDR and seeds
First use chosen with regulatory

Months 6 to 18: evidence

One or two feasibility studies or bench work at the four centers, run by medical affairs
Clinical input delivered for the indication filing
National market model and launch plan

Month 18 on: launch

National launch for each use as its label arrives, with the four centers as references
Next wave of centers, then Canada
A prostate decision, if the evidence earns one

Where I would start: four national centers.

Centers where I have contacts today, each matched to the use it can teach us most about. Medical affairs owns the contracts; I own the relationships. None is publicly an Epione site, so every one is new ground. The Tools page shows how I rank them.

Center	Use to lead with	Why start here
Stanford Cancer Institute Palo Alto, CA	Fiducial placement for SBRT and CyberKnife	Its interventional radiologists published one of the core fiducial complication series, with radiation oncology coauthors.Source HDR for gynecologic and prostate cases, with lung considered case by case.Source
Ohio State James Cancer Hospital Columbus, OH	Interstitial and seed work, and training	A brachytherapy fellowship covering prostate, interstitial gynecologic, lung and GI cases.Source Where the next implanters train, so the right place to test the learning curve.
Vanderbilt Ingram Cancer Center Nashville, TN	Early clinical evaluation and workflow	HDR and LDR across several disease sites, fiducials and spacers for prostate, and an early GammaTile program.Source An account I have worked with before.
MD Anderson Cancer Center Houston, TX	Prostate and the MRI horizon	The MARS MRI guided prostate seed program and an intraoperative MRI gynecologic brachytherapy program.Source Source The place to learn what prostate would really take. Any NeuWave relationship there stays with the NeuWave team.

Then the next wave.

The four centers prove the use and the message. The next wave is chosen by evidence in months 6 to 18: brachytherapy and SBRT volume, CT needle work, existing Epione sites, and where the first four show the most pull.

Center	Why it is a candidate
Mayo Clinic	I have sold there before, and it sets practice nationally.
UT Southwestern and UCLA	Accounts I have worked with, and large academic radiation oncology programs.
Existing Epione sites	Miami Cancer Institute was the first US site.Source A robot already in the building makes a radiation oncology study faster to start.
Other NCI designated centers	Ranked with the same scoring once the first use is clear.
Canada	Scoped after US coverage, with the right partners and regulatory review.

Candidates, not commitments. The order is a month 6 decision with leadership, and Epione sales teams keep every account they already own.

An investment first. Here is what it takes to pay back.

No radiation oncology use is cleared yet, so for the first year this role is an investment in evidence. Change the inputs: the question is how little it takes, once one use is cleared, to cover the role.

Fully loaded cost of the role, per year $300K

Margin per Epione placement with a radiation oncology buyer $400K

Margin per radiation oncology procedure $1,000

Example inputs, not Precision IO figures. Finance replaces them with real numbers in month one.

0.8Epione placements a year with radiation oncology as buyer or co owner covers the role

300radiation oncology procedures a year, about 25 a month across all sites, once a use is cleared

A new buyer

Radiation oncology as buyer or co owner of a robot, in accounts where Epione could not justify capital on ablation alone.

Utilization

More procedures per installed robot once a radiation oncology use is cleared.

First mover

Radiation oncology relationships and data before XACT or Perfint get there.

Optionality

A tested answer on prostate before R&D spends on it.

If by month 12 the evidence does not support a filing for at least one use, the role narrows or stops. That is my commitment, not just a metric.

The first 90 days, week by week.

Learning, validating and building run side by side. The day 30 checkpoint decides whether the thesis survives contact with real physicians.

Workstream

LearnBuildLaunch

12345678910111213

Learn the businessWeeks 1 to 4

Observe Epione cases, learn the label, meet regulatory and medical affairs

Open the four centersWeeks 2 to 8

Radiation oncologists, physicists and the IR teams who place fiducials

Map the workflowsWeeks 4 to 10

Fiducials, interstitial HDR and seeds, step by step

Size the marketWeeks 6 to 12

Center volumes plus Medicare claims

Seat the advisory boardWeeks 9 to 13

Physician and physicist seats at all four centers

Checkpoint	Validate	Build	Done when
Day 30	What the label allows, and regulatory's view of an expanded indication Who places fiducials and catheters at each center, and how many What R&D thinks of brachytherapy and prostate	Observe Epione cases with the clinical team First meetings at all four centers Interview guide approved by medical affairs	A one page verdict on each use Scorecard agreed with my manager
Day 60	Whether placement is a pain worth paying to fix Complication and redo rates each center sees Interest in a study	20 structured interviews across the four centers Workflow maps for three uses Advisory board candidates	First use chosen with regulatory Evidence gaps written down
Day 90	Every objection, how often it came up, and what answered it	Advisory board seated A study concept for the first use, with medical affairs First market sizing	Study concept in internal review 12 month plan approved

What success could look like in 12 months.

Read each row left to right. Evidence on top, market building underneath. Every number is an initial target to confirm with leadership by day 30.

Milestone	Day 90	Month 6	Month 12
Evidence
Advisory board	Seatedseats at all four centers	2meetings, workflows captured	Rankeduses and unmet needs to R&D, through medical affairs
Studies	Conceptfor the first use	1 to 2centers approved	Dataenrolling, or bench work complete
Regulatory	Questionsto regulatory and R&D	Pathagreed for the first use	Inputdelivered for the filing
Market building
Champions	20structured interviews	8engaged across the four centers	15engaged nationally, beyond the first four
Market sizing	Draftfrom four centers	Modelnational, with claims data	Forecastfor launch planning
Playbook	Draftedmessaging for radiation oncology	Testedwith 2 center teams	Readyfor the day the label allows

The scorecard.

Six measures, set with leadership by day 30 and reviewed at month 6 and month 12. If month 6 misses badly, the role narrows or stops.

Director, Radiation Oncology Market DevelopmentProposed scorecard · year one

ActivityDay 60

Structured interviews across the four centers

AccessDay 90

Centers with an advisory board seat and a named champion

EvidenceMonth 6

Use chosen with regulatory, with a study concept approved

RegulatoryMonth 12

Input

Clinical input delivered for an expanded indication

DecisionMonth 12

Go / no go

On each radiation oncology use, prostate included

Pays its wayAfter clearance

≥ cost

Placements and procedures against the role's cost, baselined with finance

Due by this point in year oneEvery number is a proposal. Before a cleared indication, this role carries no quota; it is measured on evidence, access and launch readiness.