Twenty years in healthcare software
I started at Take Care Health (acquired by Walgreens) in 2006, writing data adapters for legacy clinical systems and building the API layer that powered the EMR/EHR web app supporting every part of the business. I learned, early, that real healthcare software is mostly integration work — that the interesting problems live at the seams.
In 2013 I joined New Ocean Health at founding and spent nearly a decade as CTO, building the engineering org from zero, designing FHIR-based APIs, moving the platform to Azure, and shepherding HITRUST certification end-to-end. After that I scaled engineering at Brightside Health (30+ engineers, EHR interoperability, Medicare reimbursement work) and then took the CTO seat at aptihealth, owning product, engineering, and data platform across the company.
Why this practice exists now
I joined Altitude in 2025 to lead a company-wide pivot from a rule-based clinical decision engine to an LLM- and agent-driven pipeline. I designed the agent orchestration layer, replaced the rules engine with an LLM-powered reasoning system, and built the evaluation and governance framework that lets clinical AI ship safely. We took an Athenahealth EHR integration through Marketplace approval. We operationalized HIPAA and SOC 2 programs on accelerated timelines. And the whole organization — engineering, product, ops, clinical, GTM — adopted AI tooling at the same time.
In the process it became obvious that other healthcare companies need exactly this kind of senior, hands-on AI engineering. Not a prompt consultant. Not a Zapier patcher. Not a $5K project that doesn't survive an audit. They need someone who's already been through the matrix of clinical safety, regulatory posture, real production deployment, and stakeholder management, and who can build alongside their team.
Betz Software is the practice for that work — done at the evenings-and-weekends pace of a senior who already has a day job, and at the senior price.
How I work
Senior, embedded, owner-grade. I show up like a CTO. I read your code, your docs, and the room. I ship working software, not slide decks. I leave the team better than I found it: documentation they own, evaluation harnesses they can run, governance they can defend.
Honest about limits.I have a full-time role. That means a small number of clients, capped capacity, and a clear conversation about scope before any engagement. If I'm not the right fit, I'll say so on the first call and refer you to someone who is.
Pricing in the open.Senior work doesn't hide its prices. Build engagements are $15K–$30K. Fractional is $5K–$15K/mo with a 3-month minimum. The first call is free and has a real chance of ending with “you don't need this.”