The global digital health market is projected to exceed $660 billion by 2025, yet many startups fail due to poor technical leadership and scalability challenges. Early-stage founders often struggle to justify the cost of a full-time fractional healthcare CTO while still needing expertise in compliance, architecture, and product strategy.
This is especially critical in healthcare software development, where HIPAA compliance, EHR integrations, and secure data handling are non-negotiable. Most EHR integration projects fail, and fractional healthcare CTOs offer a practical solution by providing strategic and technical leadership without long-term overhead, helping startups move faster while reducing risk.
At Technology Rivers, we work closely with healthcare startups, founders, and technical leaders to design and build scalable digital health products. In many of these engagements, we collaborate with fractional CTOs, technical advisors, and in-house engineering leaders to bring products from idea to launch.
How We Selected These Fractional Healthcare CTOs
Choosing the right fractional CTO for digital health startups requires more than just technical experience. For this list, we evaluated leaders based on their healthcare domain expertise, experience with regulated environments, and ability to guide startups through early product development and scaling. We also considered their knowledge of cloud architecture, AI integration, and interoperability standards such as HL7 and FHIR.
This list is based on our experience working alongside CTOs across different stages of growth, from early MVP development to scaling complex, compliant healthcare systems. The goal is to highlight individuals who bring relevant expertise in healthcare, SaaS, and product architecture, and who can support startups in making informed technical decisions.
1. Todd Merrill
Todd Merrill is a healthcare-focused fractional CTO with deep experience in SaaS platforms, cloud infrastructure, and regulated systems. He is particularly well-suited for startups building HIPAA-compliant applications that require secure architecture and scalable backend systems. His background in designing enterprise-grade solutions makes him a strong fit for teams preparing to scale or integrate with complex healthcare ecosystems.
Looking to build a HIPAA compliant app? Download our HIPAA Compliance Checklist for Mobile & Desktop.
2. Mark Olszewski
Mark Olszewski brings extensive experience in healthcare technology leadership, particularly in health data platforms and provider-focused solutions. He has worked closely with organizations navigating interoperability challenges and data-driven decision-making. His expertise is valuable for startups building products that rely heavily on clinical data, analytics, and integrations with healthcare providers.
3. David Orban
David Orban is a technology advisor known for supporting innovation-driven initiatives across healthcare and AI. His strength lies in helping startups define long-term product vision and align emerging technologies with business strategy. He is especially relevant for companies exploring AI-powered healthcare solutions or entering new, evolving markets.
4. Michael Kirven
Michael Kirven is a CTO-level consultant with strong experience in SaaS and healthcare systems. He helps startups design scalable cloud architectures and modernize their technology stacks. His approach focuses on building reliable, flexible platforms that can grow with the business, making him a solid choice for early-stage companies planning rapid expansion.
5. Scott Sambucci
Scott Sambucci is a B2B SaaS advisor who supports founders with early technical direction and vendor selection. While not exclusively healthcare-focused, his experience in guiding startups through initial product and scaling decisions makes him valuable for digital health founders navigating early uncertainty. He brings clarity to technical decision-making during critical growth stages.
6. Jason Bloomberg
Jason Bloomberg is a recognized leader in digital transformation and enterprise architecture. He has advised organizations across industries, including healthcare, on managing complex technology ecosystems. His expertise is particularly relevant for startups operating in enterprise healthcare environments or dealing with large-scale integrations and legacy systems.
7. Eric Austvold
Eric Austvold works as a fractional CTO for healthtech and SaaS startups, focusing on product architecture and delivery execution. He helps teams translate business requirements into scalable technical solutions while maintaining development velocity. His hands-on leadership style is beneficial for startups that need both strategic direction and operational support.
8. Joe Hyrkin
Joe Hyrkin is a technology executive and advisor with experience guiding teams building secure and scalable platforms. While his background spans multiple industries, his expertise in platform architecture and security is applicable to healthcare startups dealing with sensitive data and compliance requirements. He is well-suited for companies prioritizing reliability and performance.
9. Chris Dancy
Chris Dancy focuses on health data, digital wellness platforms, and behavior-driven technology products. His work centers around leveraging data to improve user outcomes and engagement. He is particularly relevant for startups building consumer-facing health applications or products that rely on behavioral insights and personalization.
10. Brian de Haaff
Brian de Haaff is a product and technology advisor known for helping software companies improve product strategy and execution. His expertise lies in aligning product development with business goals and improving decision-making processes. For healthcare startups, this can translate into more efficient product roadmaps and stronger market positioning.
Choosing the Right Fractional Healthcare CTO
Selecting the right fractional healthcare CTO depends on your startup’s stage, product complexity, and regulatory requirements. Some advisors are better suited for early-stage strategy and MVP planning, while others bring deep expertise in scaling infrastructure, managing engineering teams, or navigating enterprise healthcare environments.
It is also important to consider whether you need purely advisory support or a partner who can assist with execution. In many cases, startups benefit from combining strategic leadership with a capable development team that understands healthcare compliance, integrations, and long-term scalability.
Final Recommendation
There is no one-size-fits-all choice when it comes to fractional CTO support. Founders should prioritize candidates who align with their product vision, understand healthcare regulations, and have experience guiding startups through similar growth stages.
Before making a decision, evaluate each option based on technical depth, communication style, and ability to translate business goals into actionable product strategies. For teams building in regulated environments, ensuring experience with compliance frameworks and secure architecture is essential.
FAQs
What is a fractional healthcare CTO?
A fractional healthcare CTO is a part-time or contract-based technology leader who provides strategic and technical guidance to healthcare startups. They help with architecture decisions, compliance planning, and product development without the cost of a full-time executive.
When should a healthcare startup hire a fractional CTO?
Startups typically hire a fractional CTO during early or growth stages when they need technical leadership but are not ready to hire a full-time CTO. This is especially useful when building MVPs, scaling infrastructure, or preparing for compliance requirements like HIPAA.
How is a fractional CTO different from a technical advisor?
A fractional CTO is more hands-on and involved in execution, often guiding engineering teams and making architectural decisions. A technical advisor usually provides high-level guidance without being deeply involved in day-to-day development.
Do fractional CTOs help with HIPAA compliance?
Yes, many fractional healthcare CTOs have experience with HIPAA compliance, secure data handling, and healthcare integrations such as EHR or EMR systems. However, their level of involvement can vary, so it is important to evaluate their experience in regulated environments.
Can a fractional CTO help build a healthcare MVP?
Yes, a fractional CTO can define the technical roadmap, select the right tech stack, and guide development teams during MVP creation. Some also assist with vendor selection or work alongside development partners to ensure the product is scalable and compliant.
What should you look for in a fractional healthcare CTO?
Key factors include healthcare domain experience, understanding of compliance requirements, experience with scalable cloud architecture, and the ability to align technology decisions with business goals. Strong communication and startup experience are also important.
