Healthcare Solution Architecture

Most healthcare organizations do not need a full-time CTO. They need senior technical judgment on a schedule that fits their reality. Architecture reviews when a platform decision is about to get expensive. Technology selection when the sales demos all look the same. Vendor evaluation when the contract renewal is coming up and nobody is sure the current tool is worth what it costs.

The problem

I keep running into the same situation. A healthcare company has a small engineering team, a growing list of technical debt, and no one on staff with the experience to make the big calls. Someone picked a BI tool three years ago and now it does not scale. Someone else built an integration that only one person understands. The EMR upgrade keeps getting pushed because nobody can quantify the risk.

The team knows something is wrong. They cannot always articulate what, and they definitely cannot prioritize the fix. That is not a skill gap on the team. That is a missing role. You need someone who has made these decisions before, seen what happens when they go right and when they go wrong, and can give you a straight answer about what to do next.

Hiring a full-time VP of Engineering or CTO for this is overkill. You need two days of architecture review, not another headcount with benefits and a four-year vesting schedule.

What I do

Four things, depending on what you actually need:

Architecture reviews

I audit your existing systems. Data platforms, integration layers, application architecture, infrastructure. I document what is there, identify the risks, and tell you what to fix first. No boilerplate. No 80-page PowerPoint deck you will never read. A prioritized list of problems and a recommended remediation plan with realistic timelines.

Technology selection

You are choosing between two (or five) platforms and every vendor says they are the best fit. I cut through the demo theater. I evaluate against your actual data volumes, your actual compliance requirements, your actual team capabilities. You get a recommendation with a clear rationale, not a feature comparison matrix that tells you nothing.

Vendor evaluation

Is your current vendor worth what you are paying? Should you renew, renegotiate, or replace? I have done this from both sides, as the buyer and as the person building on top of vendor platforms. I know where the pricing traps are and where the "enterprise" tier stops adding value.

Interim CTO coverage

Sometimes the need is bigger than a review. Your CTO left, or your company is being acquired, or you are acquiring someone and need technical leadership during the integration. I have covered these gaps before. I have run engineering teams through M&A transitions and I know what falls through the cracks when leadership is in flux.

Technical due diligence

You are acquiring a healthcare company and the IT systems are a black box. I assess the target's technology stack, evaluate technical debt, identify integration risks, and give you a clear picture of what you are actually buying. This has saved clients from expensive surprises more than once.

Deliverables

Every engagement produces concrete output, not just opinions:

• Architecture assessment. A documented review of your current state: what works, what does not, what is at risk, and what to fix in what order. Includes diagrams where they add clarity.
• Technology recommendations. A written evaluation with a clear recommendation, scoring criteria, and a migration path if you are switching platforms. Specific enough that your engineering team can act on it without ambiguity.
• Vendor analysis. A cost-benefit breakdown of your current or prospective vendors. Where you are overpaying, where you are underserved, and what your alternatives look like.
• Interim leadership. When I cover a CTO or VP Engineering gap, you get running the engineering function, board-level technical communication, and a smooth handoff when you find the permanent hire.
• Due diligence reports. For M&A, a technical assessment of the acquisition target's systems: integration complexity, hidden risk, and a realistic estimate of what it takes to absorb their stack into yours.

Why me

Nineteen years in software engineering. Multiple industries, heavy on healthcare for the last several years. I have been the technical lead on M&A integrations where the acquirer had to absorb multiple companies into a single IT stack. I have selected, deployed, and migrated off platforms across data engineering, BI, integration, and infrastructure.

I am not a career consultant. I build things. The architecture recommendations I give you come from having implemented the alternatives and knowing which ones hold up under real workloads, real compliance audits, and real team constraints.

Multi-acquisition IT integration is a specific skill. Most people have not done it. I have, and the scars from it are what make the architecture reviews useful. I know which problems look small in a single-system environment and become catastrophic when you are merging three codebases onto one platform.