Evidence, programs, radiopharmaceutical shifts.
What landed in the literature, in pipelines, and in radiopharmaceutical supply, and the operational implications for a real practice schedule.
Issue 01 / a weekly intelligence brief
Theranostics Weekly: the intelligence brief for independent oncology operators.
Weekly signal on theranostics, reimbursement, trials, payer pressure, and the AI operating layer independent practices will need next.
Written from the perspective of a practicing radiation oncologist building inside the same operational pressure independent practices face every week.
- Theranostics Signal
- Evidence and operations
- Reimbursement Watch
- Policy and margin risk
- Trials and Ops
- Feasibility and workflow
Why this brief exists
Most oncology practices do not need another dashboard.
They need organized signal. What changed this week, what actually matters, and what to do about it before the next sponsor call, the next payer letter, or the next theranostics case on the schedule.
The brief is written from inside the same operational pressure independent practices face. Not from a vendor booth. Not from a consultancy slide deck.
Inside the brief
Three sections every Monday.
Each issue moves from clinical and scientific signal to the business reality, then to what to put on the operating board this week.
Policy changes, coverage friction, margin risk.
Coding pressure, payer policy moves, prior authorization patterns, and the quiet shifts that hit independent practice margins first.
Feasibility, sponsor communication, AI workflow.
Where feasibility breaks, how sponsor communication actually works in independent sites, staffing reality, and AI workflow experiments worth borrowing.
What we install
Three operating layers. One command board.
The rollout is scoped to PHI-light work first. No PHI enters public models. Human review remains required. We do not position any of this as clinical decision support.
Practice Intelligence Layer
A practice-specific evidence and reimbursement brief, structured around the disease sites and payer mix that actually matter to your group.
- Disease-site evidence digest tuned to your case mix
- Reimbursement and policy delta tracking
- Weekly operator brief at the group level
Trials Operating Layer
Protocol, feasibility, and sponsor communication support. The unglamorous work that decides whether a trial portfolio actually grows or quietly shrinks.
- Protocol read summaries for site leads
- Feasibility checklist with site-specific constraints
- Sponsor communication drafts with human review
Business Office Operating Layer
A payer policy log, reimbursement trend tracking, and provider financial visibility so the business office is not learning about a margin shift after the fact.
- Payer policy change log with assigned owners
- Reimbursement trend tracking by service line
- Provider-level financial visibility for partners
The 30 to 90 day rollout
From diagnostic to running on Monday.
Three phases. PHI-light first. Human review at every consequential step.
-
Days 1 to 14
Practice diagnostic
Map the actual operating pressure: case mix, payer mix, trial portfolio, business office bottlenecks, and the workflows that quietly drain partner time.
-
Days 15 to 45
PHI-light workflow install
Stand up the first operating layer against PHI-light work: policy log, evidence brief, sponsor communication drafts, with explicit boundaries and an AI policy in writing.
-
Days 46 to 90
Operating layer in production
Expand to the remaining layers, tune to the group's voice, train the operator, and leave behind a practice that runs the brief, the trials layer, and the business office layer on its own.
Safety and governance
Conservative on clinical claims. Explicit on AI policy.
Healthcare AI without guardrails is a liability story waiting to happen. The rollout is governed by rules, not vibes.
- PHI-light workflows first, before any PHI-adjacent work is even considered
- No PHI enters public models
- Human review remains required for anything that affects a patient, a payer claim, or a sponsor
- A simple written AI policy is part of every engagement
- Not positioned as clinical decision support and not used to make clinical decisions
- Conservative on clinical claims by default
For practice leadership working through healthcare AI governance, two useful starting points are the AMA on augmented intelligence in medicine and a recent PubMed review on large language models in clinical practice.
Who it is for
Independent groups under real operating pressure.
Independent oncology groups
Practices adding theranostics, expanding the trial portfolio, or trying to keep partner time off the business office floor.
Uro-Rads practices
Groups building a radiopharmaceutical line of service and the operating workflows that have to come with it.
Practices under payer pressure
Groups watching coverage friction, prior authorization burden, and reimbursement trends erode margin quarter by quarter.
Practices under PE pressure
Independent groups under private equity courtship or consolidation pressure who want operating leverage that does not require selling the group.
Get the weekly brief
Subscribe to Theranostics Weekly.
Every Monday. Theranostics signal, reimbursement and payer watch, trials and practice operations. About five minutes. Plain English. No vendor hype.
Written for partners, practice administrators, trial leads, and business office leadership at independent groups.
Practice diagnostic
Practice diagnostic.
A scoped diagnostic for independent oncology and Uro-Rads groups considering a 30 to 90 day AI operating layer rollout.
We look at case mix, payer mix, trial portfolio, business office workflow, and where AI agent tools can actually reduce partner time without touching PHI in the first phase.
Diagnostics are limited and scoped case by case. Nothing on this page is legal, financial, or medical advice. The operating layer is not clinical decision support.
Coming soon
Practice diagnostics open soon.
We are not taking diagnostic requests just yet. The weekly brief is the best way to follow the work in the meantime, and diagnostic intake will open here.
Want a heads up when it opens? Subscribe to the weekly brief above and you will hear about it there.
Agentic OS
Explore the Agentic OS.
ParallelOS is where this started: an internal operating system built because most practice software is not the answer, and the real product is an operating layer for the independent groups still holding the line.