Menu
Request a Consultation
Executive Technical Leadership
Fractional CTO Services

A seasoned CTO,
without the full-time hire.

Executive-level technical leadership for growth-stage companies and regulated enterprises — roadmapping, architecture, and delivery acceleration from operators who have run engineering inside real healthcare businesses.

Book a Leadership Session
Proven Track Record

Delivery accelerated across the
Greenleaf Ventures portfolio.

We've served as embedded technical leadership for the Greenleaf Ventures portfolio, accelerating delivery for its healthcare and Medicare operating companies — modernizing billing systems, standing up compliant integrations, and shipping roadmaps that had stalled.

That work spans the full lifecycle: assessing inherited systems, rebuilding delivery pipelines, and leading engineering teams through audits, integrations, and scale.

Portfolio Companies Served

  • Access Medical
  • Arriva Medical
  • Comfort Medical
  • Aptiva Medical
  • AptivaRx

Greenleaf Ventures healthcare & Medicare operating companies, spanning medical supply, pharmacy, and billing operations.

What You Get

Everything a CTO owns.
Scaled to what you need.

Engagements flex from a few days a month of strategic advisory to embedded, hands-on leadership of your engineering organization.

Technical Roadmapping

A concrete, sequenced technology plan tied to your business objectives — what to build, what to buy, and in what order.

Delivery Acceleration

We unblock stalled roadmaps: tightening scope, restructuring teams, and modernizing engineering workflows so releases ship on a cadence you can plan around.

Architecture & Platform Reviews

Deep reviews of your systems for scale, security, and future-readiness — with a prioritized remediation plan, not just a findings deck.

Engineering Leadership & Mentorship

Hands-on leadership for your existing team: hiring plans, career ladders, code review culture, and the operating rhythm of a high-performing org.

AI & Automation Strategy

Where agentic AI actually pays off in your operation — and where it doesn't. Honest build-vs-buy guidance grounded in production experience.

Compliance-Aware Engineering

Technology decisions made with HIPAA, CMS/Medicare, and audit requirements as design inputs from day one — not retrofits.

Not ready to talk?

Run the CTO Readiness Assessment first.

Twelve questions we ask in every first engagement — covering roadmap, delivery, architecture, compliance, and team. If you can answer all twelve comfortably, you may not need us.

Get the Assessment
How It Works

From first assessment
to a running engine.

01

Assess

We review your systems, team, and delivery pipeline to find what's actually slowing you down.

02

Roadmap

You get a sequenced technical plan aligned to business milestones — with clear owners and timelines.

03

Embed

We operate as your CTO: running the engineering org, driving delivery, and reporting to leadership.

04

Scale & Transition

As you grow, we help hire and onboard permanent leadership — or stay on in an advisory capacity.

Fractional CTO FAQ

What people ask
before they start.

The same job a full-time CTO does, sized to what you need. That means owning the technical roadmap, making build-versus-buy calls, running or rebuilding the engineering org, and reporting to the board or leadership on delivery. Engagements range from a few days a month of strategic advisory to embedded, hands-on leadership.
A consultant hands you a recommendation. We own the outcome. We sit inside your leadership team, make the decisions a CTO makes, and stay accountable for whether the roadmap actually ships.
When you need senior technical judgement now but cannot yet justify a full-time executive salary, when a search is underway and the roadmap cannot wait, or when your existing team is capable but has no one to set technical direction. It also works well ahead of a raise or an acquisition, when the technology story has to hold up to diligence.
Yes — that is the environment we come from. We have run engineering inside Medicare and healthcare operating companies, so compliance shapes the architecture from day one rather than being retrofitted after an audit finding.
We usually start with a short assessment of your systems, team, and delivery pipeline, which gives you a sequenced roadmap regardless of whether we continue. From there most engagements run for several quarters, tapering as we help hire and onboard permanent leadership.
That is the intended ending, not a failure. We help write the role, screen candidates, and hand over the roadmap and team — and we can stay on in an advisory capacity through the transition.

Still have questions?

Talk to Us

Need technical leadership
that has done this before?

Tell us where your roadmap is stuck. We'll show you how we've unstuck it before — and what it would take in your organization.

No pitch deck. A working conversation about your roadmap.

Rather look around first? See all services.