I’m a hands-on CTO for health companies where compliance is part of the product.

Since 2012 I’ve built software for labs and diagnostics companies, including a HIPAA platform that ran COVID-19 screening at population scale and passed SOC 2 Type 2 audits. Now I work as a fractional CTO and advisor to health and insurance companies, from cancer diagnostics to mental health.

Email me Download resume (PDF)

Experience

2023–

Independent

Fractional CTOSep 2023 – present

Technical and product leadership for healthcare startups and similarly regulated companies (life insurance, fintech). The work centers on HIPAA compliance, regulatory strategy and platform architecture that scales.

imaware

Consulting CTOSep 2023 – present

Hands-on leader across product, technology, security, sales, regulatory and logistics. Completed the company’s move from direct-to-consumer to B2B.

Consolidated two platforms into one and retired the paid third-party services the old one depended on, cutting cloud spend 76% from 2024 levels
Cut cost of goods per at-home test about 22% by moving to a new lab partner, simplifying kitting and changing shipping speeds
Led the repositioning from DTC to B2B, including new MSAs and pricing
Own technology, security, regulatory and operational initiatives

Cancer diagnostics company

Technical and product advisorAug 2026 – present

Architecture and product direction for the clinician and patient software around the company’s first test.

Designing the clinician portal for ordering tests and reviewing results, and its integrations with CRM, LIMS and billing
Defining patient registration, e-consent, payment and results delivery, starting with patient pay and leaving room for insurance billing
Advising on HIPAA handling of PHI, SOC 2 readiness, staffing and launch sequencing

Yosa(mental health platform)

AdvisorMar 2025 – present

Advise the founders on product, technology and strategy, and join calls with prospective clients and partners.

Life insurance agency

Technical advisorNov 2024 – present

Planned, and now oversee, the build of a platform to automate the agency’s operations.

Turned requirements into a prioritized roadmap, architecture decisions, a resourcing plan and a tooling budget so the build could start in Q1 2025
Oversee the outside developer: review code, infrastructure and architecture, and keep tooling and hosting spend on budget
Assessed the security posture, planned the path to SOC 2 Type 2 and HIPAA, and worked with the IT provider on security projects

2023–24

BalancedWork

Co-founder & CTONov 2023 – May 2024

Built an application that ingested calendar, organizational and related data to recommend ways to improve team relationships and hybrid work schedules.

2018–23

binx health(digital business acquired by imaware)

VP, Digital Product & TechnologyFeb 2022 – Aug 2023
Head of Digital ProductJul 2021 – Feb 2022
Head of Software EngineeringApr 2019 – Jul 2021
Director, Software EngineeringMay 2018 – Apr 2019

Co-founded and architected binx everywhere, the digital platform that delivered diagnostics as a service at population scale. The platform was HIPAA-compliant, completed SOC 2 Type 2 audits, and served state health departments, universities and healthcare organizations.

Built teams that combined in-person, remote, hybrid and near-shore engineers
Wrote and executed the business plan for COVID-19 population screening programs and UK expansion
Led the usability study and FDA filing for one of the first EUAs for a self-collected nasal swab
Set the product roadmap for the digital platform and the instrument software
Supported the existing binx io instrument software through its 510(k) filing and Windows 10 IoT migration
Prepared the digital business for a Series A spinout, pitched investors, and supported its sale to imaware

2012–18

Good Start Genetics(acquired by Invitae)

Engineering ManagerApr 2016 – May 2018
Lead Software EngineerMar 2015 – Apr 2016
Senior Software EngineerMay 2014 – Mar 2015
Software EngineerMay 2012 – May 2014

Technical lead and manager for the development organization: code quality, staffing, software design, enterprise architecture and people management.

Designed a hiring program that brought on 7+ developers in 6 months, plus 5 more departmental hires
Led development and architecture of VeriYou, the company’s first consumer-initiated carrier screening product
Launched a patient-first experience with insurance price transparency that improved cash flow
Ran an agile turnaround of the department that raised velocity and contributed to the sale of the company
Moved the company’s infrastructure from on-premise to AWS

2009–12

Wellington Management

Systems EngineerJan 2011 – May 2012
Systems Support EngineerJul 2009 – Jan 2011

Built software for the Legal and Compliance department that checked trades against client and government rules.

How I help

Product and technology strategy: Taking products from first idea to commercial launch, mostly in digital health and lab diagnostics.; Roadmaps, platform design, GCP and AWS, Kubernetes, cloud cost, LIS/LIMS, patient portals, M&A support
Teams: Hiring and growing engineering teams that work in person, remote, hybrid and near-shore.; Hiring programs, engineering management, cross-functional leadership
Security and compliance: Building platforms and security programs that hold up to HIPAA, SOC 2 and FDA scrutiny.; HIPAA and PHI handling, SOC 2 Type 2, FDA EUA, security operations
Business operations: Working with operations, partnerships, regulatory, finance and legal so the technology serves the business.; MSAs and pricing, vendor and partner integrations, DTC-to-B2B transitions

Writing

Engineering notes from my years writing Grails and Groovy, 2014–2016.

2016

Grails Hibernate Filters support for Hibernate 5

2016

Grails Spring Security Account Locking with Redis

2015

Grails JMS Durable Topic Subscription Name

All 8 posts

Contact

If you’re building in health or insurance and need a CTO for part of the week, email me at ackramer19@gmail.com. I’m in the Boston area and work remotely.