Fractional CTO for HealthTech Startups

Stop Burning Money on Technical Mistakes

Navigate Epic integration, HIPAA compliance, and enterprise healthcare scaling with a team that has over 20 years of experience implementing healthcare IT systems at major health systems, payers, and pharmaceutical companies.

Let's Talk About Your Tech Strategy

Healthcare is Different

Generic tech advice doesn’t work when you’re dealing with Epic integrations, HIPAA audits, and billion-dollar health system contracts.

Epic Integration Costs Spiral

You thought Epic integration would take 3 months and $50K. Now you're 9 months in, $200K over budget, and the health system is threatening to walk.

HIPAA Compliance is a Black Box

Your developers say "we're HIPAA compliant" but you have no idea what that actually means. A health system just asked for your SOC 2 report and you don't have one.

Technical Debt is Crushing You

You built fast to get to market. Now your system crashes when more than 100 users log in, and refactoring will take 6 months you don't have.

You Can't Afford a Full-Time CTO

A senior healthcare CTO costs $250K-400K plus equity. You need that expertise but you're not there yet.

Your Tech Team Doesn't Know Healthcare

Your engineers are talented, but they've never dealt with HL7, FHIR, or the nightmare of healthcare data standards. Every integration is a learning experience—expensive learning.

Investors Are Asking Hard Questions

Your Series A deck has a "Technology" slide but you're not confident explaining your architecture, scalability plan, or why Epic integration is taking so long.

We've Built What You're Trying to Build

Our team brings over 20 years of enterprise healthcare IT experience across major health systems, national payers, and pharmaceutical companies. We’ve seen what breaks at scale and how to avoid it.

20+

Years in Healthcare IT

100%

HIPAA Compliance Rate

Fortune 100

Health Organizations

$200K+

Average Client Savings

Major Health Systems

Epic, Cerner, and custom EHR implementations at enterprise scale

HIPAA & Compliance

Security architecture for PHI/ePHI across payers, providers, and pharma

Scalable Architecture

Built systems handling millions of patient records and transactions

Enterprise Contracts

Navigated procurement, BAAs, and technical diligence with major buyers

How We Help HealthTech Startups

Strategic technical leadership for the challenges that actually matter in healthcare.

Epic & EHR Integration Strategy

Stop guessing. Get a clear integration roadmap from a team that's implemented Epic at major health systems for over 20 years. We'll map your Epic integration strategy, estimate realistic costs and timelines, and guide you through App Orchard marketplace navigation.

HIPAA Compliance Done Right

Pass your next audit. We'll assess your compliance gaps and build the security architecture health systems expect. From PHI/ePHI handling to BAA preparation and penetration testing coordination, we ensure you're actually compliant—not just claiming to be.

Technical Roadmap That Gets Funded

Investors and health systems want to see a credible technical plan. We'll build a 6-12 month roadmap that demonstrates you understand healthcare complexity, with feature prioritization that resonates with health system buyers.

Healthcare-Ready Architecture

Don't learn scalability lessons the expensive way. We'll design infrastructure that handles healthcare data at scale, with disaster recovery, business continuity, and cost optimization baked in from day one.

AI That Meets Healthcare Regulations

AI in healthcare has unique compliance requirements. We'll help you build and deploy models that meet FDA and HIPAA standards, navigate clinical workflow automation, and implement predictive analytics that health systems will actually trust.

Fractional CTO Leadership

Get enterprise-level technical leadership without the enterprise price tag. Part-time CTO services tailored to your stage: technical team building, engineering best practices, investor-ready technical diligence prep, and board-level technical reporting.

Real Problems We've Solved

Telehealth Platform: Epic Integration Done Right

The Challenge

Series A telehealth startup needed Epic integration to land a major health system contract worth $2M annually. Their initial vendor quote was $400K with a 12-month timeline. The health system wanted to go live in 6 months.

Our Solution

  • Designed FHIR-based integration using Epic’s App Orchard marketplace instead of point-to-point HL7
  • Identified which Epic modules they actually needed vs. vendor upsell
  • Built phased rollout: core scheduling first, clinical data exchange in phase 2
  • Negotiated directly with Epic on their behalf using our existing relationships

The Result

  • Integration completed in 5 months, under original deadline
  • Total cost: $180K (saved $220K from original quote)
  • Health system contract signed and launched on schedule
  • Architecture now reusable for next 10 health system integrations

Remote Patient Monitoring: HIPAA Crisis Averted

The Challenge

Pre-Series A RPM startup landed a pilot with a major regional health system. During contracting, the health system’s security team found multiple HIPAA violations in their code. They had 30 days to remediate or lose a $500K pilot contract.

Our Solution

  • Emergency security audit of entire codebase and infrastructure
  • Fixed critical issues: unencrypted PHI in logs, weak access controls, missing audit trails
  • Implemented proper encryption at rest and in transit
  • Created documentation package for health system security review
  • Built ongoing compliance monitoring system

The Result

  • All critical issues resolved in 3 weeks
  • Passed health system security review on first attempt
  • $500K pilot contract saved and launched
  • Now compliant for enterprise health system sales
  • Built foundation for SOC 2 certification

Healthcare Analytics: Architecture That Scales

The Challenge

Seed-stage healthcare analytics company built MVP on single database. Growth accelerated—100 customers to 500 in 6 months. System started crashing daily. CTO quit. Board demanded immediate fix.

Our Solution

  • Stepped in as interim CTO while they searched for permanent hire
  • Diagnosed bottlenecks: monolithic database, no caching, inefficient queries
  • Designed microservices architecture with proper data partitioning
  • Implemented Redis caching layer and read replicas
  • Rebuilt analytics engine to handle 10M+ patient records
  • Hired and onboarded new permanent CTO

The Result

  • System stability restored in 6 weeks
  • Architecture now supports 2,000+ customers without issues
  • Query performance improved 10x
  • Infrastructure costs decreased 40% through optimization
  • New CTO onboarded with solid technical foundation
  • Company raised Series A 4 months later

How We Work

Clear process. No surprises. Results you can measure.

Discovery Call

30-minute conversation to understand your technical challenges, timeline, and budget. No sales pitch—just honest assessment of whether we can help.

Technical Assessment

Deep dive into your current systems, code, and architecture. We identify critical issues, quick wins, and long-term strategy. Delivered as detailed written assessment.

Proposal & Roadmap

Clear proposal outlining scope, timeline, deliverables, and pricing. You'll know exactly what you're getting and when. No vague consulting-speak.

Execution & Results

We roll up our sleeves and do the work. Regular check-ins, clear milestones, measurable outcomes. You'll always know where we are and what's next.

Flexible Engagement Models

Whether you need a one-time project or ongoing leadership, we have a model that fits.

Strategic Advisory

Perfect for early-stage startups who need guidance but not hands-on execution.
$ 5k Monthly
  • 2 strategy calls per month
  • Technical roadmap review
  • Architecture guidance
  • Email/Slack support
  • Investor deck review
Get Started

Fractional CTO

Most popular. Part-time CTO services with hands-on execution.
$ 15k Monthly
  • ~40 hours per month
  • Weekly strategy sessions
  • Hands-on architecture work
  • Team leadership & hiring
  • Vendor negotiations
  • Investor & board reporting
  • On-call for critical issues
Get Started

Full Partnership

For companies needing comprehensive technical leadership across multiple initiatives.
$ 25k Monthly
  • ~80 hours per month
  • Everything in Fractional CTO
  • Multiple concurrent projects
  • Team training & development
  • M&A technical diligence
  • Product strategy partnership
  • Priority response time
Get Started

Project-based engagements also available. Epic integration planning ($12K-25K), HIPAA compliance audit ($10K-20K), architecture redesign (custom pricing).

Frequently Asked Questions

Everything you need to know about working with a fractional CTO for your healthtech startup.

You should consider a fractional CTO when you’re facing critical technical decisions but aren’t ready to hire a full-time CTO at $250K-400K per year.

Common scenarios:

  • You’re negotiating with a health system that’s demanding technical documentation you don’t have
  • You need to integrate with Epic but don’t know where to start or what it will really cost
  • Investors are asking hard questions about your technical strategy and scalability
  • Your “HIPAA compliance” is just a checkbox, not actual security architecture
  • You’ve raised seed/Series A and need to build or scale your technical team
  • Your current CTO left and you need immediate interim leadership

If you’re at an inflection point where technical decisions will make or break your business, but you can’t afford (or don’t need) a full-time CTO yet, fractional is the right model.

Full-Time CTO:

  • Cost: $250K-400K + equity
  • Commitment: Permanent hire
  • Timeline: 3-6 months to find and onboard
  • Best for: Series B+ companies with $2M+ engineering budgets

Fractional CTO:

  • Cost: $60K-300K per year (part-time engagement)
  • Commitment: Flexible, month-to-month or project-based
  • Timeline: Start immediately
  • Best for: Seed to Series A, specific projects, or interim leadership

Think of it this way: a fractional CTO gives you enterprise-level expertise exactly when you need it, without the overhead and commitment of a full-time executive hire. You get 20+ years of healthcare IT experience for a fraction of the cost.

 

We offer three engagement models to fit different needs and budgets:

Advisory ($5K/month): Perfect for early-stage startups who need strategic guidance but not hands-on execution. Includes 2 strategy calls per month, technical roadmap review, and email/Slack support.

Fractional CTO ($15K/month): Our most popular tier. Approximately 40 hours per month of hands-on work including architecture design, vendor negotiations, team leadership, and investor/board reporting.

Full Partnership ($25K/month): Comprehensive technical leadership with approximately 80 hours per month. Best for companies managing multiple concurrent initiatives or needing interim CTO coverage.

Project-Based: Custom pricing for specific engagements like Epic integration planning ($12K-25K), HIPAA compliance audits ($10K-20K), or architecture redesigns.

Not sure which tier fits your needs? Schedule a free consultation and we’ll recommend the right level of engagement for your situation.

Yes, we focus exclusively on healthtech startups. Here’s why:

Healthcare IT is fundamentally different from general software development. Epic integration isn’t just “another API.” HIPAA compliance isn’t just “security best practices.” Health system sales cycles require understanding clinical workflows, IT procurement, and enterprise healthcare dynamics.

With over 20 years implementing healthcare IT systems at major health systems, payers, and pharmaceutical companies, we’ve seen every technical challenge healthtech startups face—and the expensive mistakes they make.

Our clients include:

  • Telehealth platforms
  • Remote patient monitoring companies
  • Healthcare data analytics startups
  • Practice management software
  • AI diagnostics and clinical decision support
  • Digital therapeutics

If you’re building technology that touches healthcare, we understand your world. That’s our focus, and that’s where we deliver the most value.

1. Discovery Call (30 minutes, free):
We discuss your technical challenges, timeline, and budget. No sales pitch—just an honest assessment of whether we can help.

2. Technical Assessment (1-2 weeks):
Deep dive into your current systems, code, and architecture. We identify critical issues, quick wins, and long-term strategy. Delivered as a detailed written assessment.

3. Proposal & Roadmap:
Clear proposal outlining scope, timeline, deliverables, and pricing. You’ll know exactly what you’re getting and when.

4. Execution & Results:
We roll up our sleeves and do the work. Regular check-ins, clear milestones, measurable outcomes. You’ll always know where we are and what’s next.

Most clients start seeing results within the first month, whether that’s a clearer technical roadmap, resolved compliance issues, or a path forward on Epic integration.

Absolutely. Epic integration is one of our core specialties.

We’ve implemented Epic at major health systems for over 20 years. We know what works, what doesn’t, and how to avoid the $200K mistakes most startups make.

Here’s how we help:

  • Design FHIR-based integration strategy using Epic’s App Orchard marketplace
  • Provide realistic cost and timeline estimates (not vendor upsell)
  • Identify which Epic modules you actually need vs nice-to-have
  • Build phased rollout plans that get you live faster
  • Navigate Epic’s certification and App Orchard requirements
  • Leverage our existing Epic relationships for faster approvals

Most startups underestimate Epic integration by 6-12 months and $150K-250K. We help you avoid that by getting it right the first time.

We don’t just check compliance boxes—we build security architecture that health systems actually trust.

Our approach includes:

  • Comprehensive security audit of your codebase and infrastructure
  • PHI/ePHI handling assessment and remediation
  • Encryption at rest and in transit implementation
  • Access controls, audit logging, and monitoring systems
  • Business Associate Agreement (BAA) preparation
  • Security documentation packages for health system reviews
  • Ongoing compliance monitoring and updates

Many startups claim to be “HIPAA compliant” but can’t pass a health system’s security questionnaire. We’ve architected HIPAA compliance at Fortune 100 healthcare organizations—we know what enterprise buyers actually require, not just what’s technically compliant.

Our goal: you pass security reviews on the first attempt, not after months of back-and-forth that kills your deal.

That’s completely normal—and exactly why we start with a free discovery call.

During our 30-minute conversation, we’ll discuss:

  • Your current technical challenges and pain points
  • Your timeline and urgency
  • Your budget and funding stage
  • What success looks like for your business

Based on that conversation, we’ll recommend the engagement model that makes the most sense for you—whether that’s Advisory for strategic guidance, Fractional CTO for hands-on work, or a project-based engagement for a specific need.

We’re not here to upsell you. We’re here to solve your problem in the most efficient, cost-effective way possible. Sometimes that’s a $5K/month advisory engagement. Sometimes it’s a one-time $15K project. We’ll be honest about what you actually need.

No obligation, no sales pressure—just a straightforward conversation about your situation and how we might help.

Still Have Questions?

Every healthtech situation is unique. If the FAQ didn’t cover your specific challenge, let’s talk about it.

Book a free 30-minute consultation to see if fractional CTO services are right for you.

Schedule Free Consultation

Schedule Your Free 30-Minute HealthTech CTO Consultation

Let’s talk about your specific situation. No sales pitch—just an honest conversation about whether we can help.

 
In 30 minutes, we’ll cover:
 
✓ Your biggest technical challenge right now
✓ Epic/EHR integration strategy and realistic costs
✓ HIPAA compliance architecture for your use case
✓ Technical roadmap and scalability concerns
✓ Whether fractional CTO services make sense for you
 
This is a pressure-free conversation. Our team has over 20 years of experience implementing healthcare IT systems at major health systems, payers, and pharmaceutical companies. If we’re a fit to work together, great. If not, we’ll point you in the right direction anyway.
What You’ll Get From This Call:
  • Honest technical assessment – We’ll look at your actual situation, not what a sales brochure says
  • Healthcare-specific guidance – Epic integration, HIPAA compliance, EHR workflows, payer systems—this is what we do
  • Clear next steps – Whether that’s working together, hiring differently, or tackling it yourself with a better strategy
  • No pressure – This is a conversation, not a sales call. You’ll know within 5 minutes if we’re a fit.
 
Come prepared with:
  • Overview of your healthtech product
  • Your immediate technical challenge
  • Current team size and structure
  • Any specific questions you have

Get in Touch

Not ready to schedule? That’s okay. Send us your questions and we’ll get back to you within 24 hours.

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