Regulated markets
Fractional CTO Services for Healthcare Companies
If you are looking for fractional CTO services for a healthcare company, this is what the engagement looks like: senior technical leadership two or three days a week, owning your architecture, your PHI boundary, your answers to enterprise security reviews, and your engineering hires. Published pricing, no equity, three-month minimum, then month to month.
I built SYNCHFIT, an AI fitness product, which put me where health data, machine learning, and consumer expectations collide, and I hold an M.Tech in Cybersecurity, so access control and data protection are the discipline I trained in rather than a checklist I downloaded. Healthcare is the market where the decisions you make in month one are the hardest to reverse in year two.
The pattern repeats whether the company is a six-person digital health startup or an established provider building software in-house: the team ships fast, wins a pilot with a provider, a payer, or an employer, then discovers PHI scattered across six systems with no audit trail and no BAA in sight. Unwinding that costs more than building it correctly would have.
What I'm hired to own
The healthcare decisions that are cheap now and expensive later
PHI leaks into systems that were never scoped for it
Analytics tools, log aggregators, error trackers, LLM providers, support desks, spreadsheets. Almost nobody puts patient data in these deliberately; it arrives through a debug log, a crash report, or a well-meaning export. I draw an explicit data boundary, get PHI out of everything that does not need it, and make sure every vendor that still touches it has a BAA in place, before a security review finds it for you.
Tracking pixels on patient-facing pages are a disclosure nobody signed off
Marketing pixels and session-replay scripts on a symptom checker, an appointment flow, or a patient portal can send identifiable health information to an ad platform. It is one of the most commonly reported failures in the sector and it is almost always the marketing stack, not the product team, that introduced it. I audit what is loading on patient-facing surfaces and separate the pages that may carry third-party scripts from the ones that never can.
You cannot prove who accessed what
HIPAA expects an audit trail, and so does every health system that will ever buy from you. Bolting immutable, queryable access logging onto a live system is painful and slow; designing for it up front costs almost nothing. I make that call early, and I make sure the logs answer the question an auditor actually asks, which is who saw this record and when, not which service emitted a line.
Interoperability decides which deals you can close
FHIR and HL7 support is the difference between a pilot and a health system contract, and an EHR integration is a procurement process as much as an engineering one. I scope what you actually need for the deal in front of you rather than the standard in full, so you are not building an integration layer for customers you do not have yet, and so the slice you do build extends without a rewrite.
Your vendor chain is longer than your BAA list
Every subprocessor your vendors use is part of your compliance surface, and model providers are the newest and least understood link in it. I map the chain, get the agreements and the data-retention terms in writing, and rule out the tools that cannot be made safe, which is a much cheaper conversation before you have built on top of them.
SOC 2 arrives with your first enterprise deal
Providers, payers, and large employers will ask, and some will ask for HITRUST on top of it. I sequence the controls so the evidence exists when the questionnaire lands, instead of stalling a signed deal for four months while you retrofit policies and screenshots.
AI features in a clinical context need a defensible story
If a model output influences care, you need to explain the training data, the evaluation, the human in the loop, and the failure mode, to a buyer and possibly to a regulator. I build that record as the feature is built rather than reconstructing it under pressure, and I am blunt about the features where the defensible answer is that the model should not be making that call at all.
How an engagement runs
Week one, month one, month three
Week 1
I find out what is actually true
Architecture review, codebase read, and honest conversations with every engineer you have. You get a written assessment at the end of it: what is solid, what is risky, what is going to break, and what it costs to fix each one. No slide deck, just a document you can act on.
Month 1
The bleeding stops and the roadmap becomes real
I fix or contain the things from week one that were actually urgent, and rebuild the technical roadmap so it has dates you can believe. If you are hiring, the role is written and the interview loop exists. If you are pre-launch, scope gets cut, usually by a lot.
Month 3
It runs without me in the room
Ship cadence is predictable, the team knows the standard, security and infrastructure are at the level your customers expect, and the decisions are documented. If the engagement is a bridge to a full-time CTO, this is where I start hiring my replacement.
Why me, for this specifically
Experience, not a capabilities deck
Plenty of people can advise on healthcare. Fewer have shipped in it, been wrong in it, and had to fix it with their own name on the commit. Here's what I'm bringing.
- Built SYNCHFIT, an AI-driven fitness and health product
- M.Tech in Cybersecurity: access control and data protection are the core discipline, with 30+ academic citations
- Have taken regulated products through enterprise security review, including redrawing a PHI boundary to unblock a stalled pilot
- Full-stack and hands-on: I write the code, not just the policy document
- Six times a technical co-founder, so I scope for the deal you are trying to close rather than for the architecture diagram
Pricing
Priced at $50 an hour. Not counted at it.
My standard rate is $100 an hour; until December 2026, or until I join a new venture full time, whichever comes first, I am holding it at $50 and the retainers are sized from that. The hours are a floor I commit to rather than a cap I bill against. If a week needs more, it gets more. A full-time CTO in the US runs about $260,000 a year before equity; I'll do that job for $30,000 at 150% commitment. Three-month minimum, then month to month.
It does not all have to be cash. The split is negotiable, from a small equity component up to roughly half and half, depending on your stage and how long we expect to work together.
Technical Advisor
$750
per month
Minimum 15+ hours a month
A senior technical brain on call. For founders who mostly need the big decisions checked rather than someone in the codebase.
Fractional CTO
$2,500
per month
Minimum 50+ hours a month
Around 50 hours a month as your acting CTO, usually two days a week. I own technical direction, and the roadmap ships because someone senior is accountable for it.
Embedded CTO
$4,000
per month
Minimum 80+ hours a month
Around 80 hours a month, usually three days a week, hands on the keyboard. Everything above, plus I build the hard parts myself instead of delegating them.
Questions
Healthcare, specifically
Where can I find fractional CTO services for healthcare companies?
You have found one, and this page is the whole offer rather than a landing page in front of a sales process. Beyond me, the market splits three ways: specialist healthcare technology firms, general fractional CTO marketplaces, and individual operators. Whichever you look at, three questions sort them quickly. Has this person actually shipped a product that handled PHI, or only advised on one? Will they write code and own architecture, or produce documents? And is the price published, or does it require three calls to discover? My answers are yes, yes, and it is on this page.
Do you work with healthcare companies that are not startups?
Yes. The work looks different: an established provider or payer-facing company usually has systems that already work and a compliance posture that already exists, so the job is less about building from zero and more about owning the architecture of a new product line, cleaning up a data boundary that has drifted, or leading a team through a platform decision nobody senior is available to make. The retainers are the same shape either way.
Are you a HIPAA compliance consultant?
No. I am the engineering leader who makes the architecture compliant. For formal audits and legal sign-off you want a specialist firm, and I work alongside them. What I own is making sure the system they audit is actually built correctly. I am a security-first engineer with a Masters in the field, so getting a company compliance-ready is the work itself rather than a side effect of it.
Can you help us pass a health system's security review?
Yes. I have taken products through enterprise security questionnaires and I know which answers block deals. Most of the work is done months before the questionnaire arrives; by the time it lands, you are describing a system that was already built for the answer rather than negotiating with the reviewer.
We want to add AI to a clinical workflow. Where do we start?
With the failure mode, not the model. What happens when it is wrong, who reviews it before it reaches a patient or a clinician, and what gets logged. Get that right and the model choice is the easy part, and often the smaller, cheaper model is the correct one once a human is reviewing the output anyway.
What does a fractional CTO for a healthcare company cost?
The same published retainers as any other engagement, listed on this page and in full on the main fractional CTO page. There is no regulated-industry premium. What healthcare does change is sequencing rather than price: the data boundary and the audit trail move to the front of the roadmap, because they are the two things that get exponentially more expensive the longer they wait.
More general questions about cost, commitment, and how this compares to a full-time CTO are answered on the main fractional CTO page.
Earned, Not Claimed
What the founders and teams I build with say
Kunal Vohra, founder of Panicletech, has been an incredible technology partner and a great friend. His dedication is rare. Whether it's solving an unexpected challenge, brainstorming a complex feature, or stepping in when something needs urgent attention, Kunal is always there. He approaches CashMyCell as if he were building his own business, and that level of commitment has been invaluable.
Jitendra Mansharamani
Founder, CashMyCell
Kunal is one of those technical leaders whose work you can't help but follow. Even without having worked directly alongside him, the impact of his engineering vision and the standard of execution he brings to the tech community are clear. He consistently demonstrates what high-level technical direction should look like: sharp, innovative, and focused on real business value.
Raman Sawhney
AWS Architect
We worked with the Panicle team in our early stages. They've been helpful and collaborative. They understood our early requirements and helped us go live.
Jeevant Sarma
Co-Founder, Thought Pudding
Building in healthcare? Let's talk.
Thirty minutes. Tell me what you're building and where it's stuck, and I'll give you a straight answer on whether I can help.
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