I had an idea to solve some of the issues that the radiation therapy industry faced with patient positioning and custom blocks. I began .decimal, a medical device manufacturing business in the radiation therapy industry, on a third story apartment balcony with $1,500 of borrowed money. Thirty one years later, .decimal has 35 CNC milling machines and 50,000 square feet of manufacturing space. .decimal has also spun off several new startups, including:ProKnow: a high impact, low cost software to reduce variability and improve patient care. Critical areas of need include contouring and treatment planning, neither of which are solved by new equipment. Our cloud-based platform provides the tools for objective assessment of practical skills, targeted education, and robust documentation to increase quality and build a competitive advantage. In addition, by utilizing our cloud expertise, we've developed a platform for big data analysis of large patient datasets. The road has not always been easy, but absolutely worth it knowing that the company has served 60,000+ cancer patients with over 330,000 patient-specific devices ... and still counting.