Fractional CISO & CTO for Regulated Industries

I find what's broken. I fix it.

I came to security from engineering, not from compliance — and that’s the difference.

Technology leadership for companies where getting it wrong has real consequences — medical devices, health software, legal, financial services. Architecture, cloud, and the security work most technology leaders can’t do themselves. You get me, not a junior.

View My WorkHow I Work
20+
Years Experience
2
Exits
5+
Industries
$33M
Budget Managed
Process

How I Work

Two ways to work together. Both have clear scope and no surprise invoices.

MODEL A

Fixed-Price Projects

Assessment, remediation, migration. Fixed scope, fixed price, defined end date.

01
PHASE 01

Discovery & Assessment

1–2 weeks, fixed fee

I embed with your team, audit your systems, and interview stakeholders. Depending on the engagement that means threat modeling, reviewing your architecture and cloud posture, working through penetration test findings, or assessing where your documentation falls short of what a regulator expects. You get a technical assessment with a prioritized remediation roadmap — not a slide deck, a real plan with real estimates.

02
PHASE 02

Scoped Engagement

4–12 weeks, fixed price

Fixed-price proposal with clear deliverables, milestones, and a defined end date. I do the work: close the findings, harden the platform, build the integration, migrate the data. No scope creep, no hourly surprises.

03
PHASE 03

Delivery & Handoff

Payment on completion

Working software, closed findings, and documentation that holds up under audit — plus your team trained to maintain it. You own everything. No dependency on me — if you want ongoing support, that’s a separate conversation, not a condition of the work. If you need me again, you know where to find me.

MODEL B

Fractional Technology Leadership

Ongoing technical ownership for companies too small for a full-time CTO and too regulated to go without one.

I take on the technology leadership role on a monthly basis — architecture ownership, cloud cost and posture, build-versus-buy decisions, premarket and post-market cybersecurity, vendor and audit response, and the hands-on engineering to close findings rather than just document them. Defined monthly scope, no hourly billing.

What a fractional CISO / CTO engagement covers →
SERVICE

Penetration Test Remediation

You’ve got a thorough report full of findings and no one to close them. Testing firms can’t remediate their own findings without compromising their independence as the assessor — so the report lands and the work stalls. I close findings, document the remediation so it holds up for a regulatory reviewer, and get you back through retest.

What remediation involves →
SERVICE

FDA Cybersecurity Remediation

A deficiency letter with a 180-day clock on it, or a premarket submission with a cybersecurity package nobody is confident in. FDA wants uniquely identified testable requirements traced to verification evidence, not security principles — and that conversion is most of the work. Connected devices and software-only products alike.

What the engagement involves →
Work

Case Studies

Real problems, real solutions. Here's what it looks like when I get involved.

Challenge

Cloud-hosted clinical platform approaching an FDA 510(k) submission with critical security and compliance gaps. A gap between the cybersecurity documentation an FDA submission requires and the state of the platform underneath it.

Approach

Ran a comprehensive security and compliance audit across cloud infrastructure, application security, and data governance. Identified and prioritized critical vulnerabilities. Led modernization of the legacy clinical portal to HIPAA-compliant, audit-ready architecture on current infrastructure.

Result

Cybersecurity remediation carried through to 510(k) submission. Audited submission security claims against the shipped product and reconciled the documentation to as-built behavior. Used production traffic to establish which interfaces were genuinely in use and retired the rest, reducing attack surface ahead of testing. Scoped and managed independent third-party penetration testing and drove findings to closure. Also delivered a substantial reduction in cloud infrastructure spend in the opening weeks of the engagement.

Medical DeviceHIPAAFDA 510(k)Threat ModelingPenetration TestingSection 524B
Challenge

A business email compromise. Attacker access of unknown scope and duration, and no clear picture of what had been reached.

Approach

Ran the forensic investigation to establish scope and timeline. Contained the compromise and hardened the identity layer — Microsoft 365 and Entra ID configuration, access controls, and authentication policy.

Result

Compromise contained and scope established. Identity infrastructure hardened against the attack path that was used.

Incident ResponseDigital ForensicsMicrosoft 365Entra IDIdentity Hardening
Challenge

Aging Java monolith EMR (3,800+ source files, 500+ database entities, 23 third-party integrations) was unmaintainable and couldn’t scale. A proof-of-concept validated the new product direction, but needed a production-grade architecture to replace it. No development team. No CI/CD. HIPAA compliance gaps.

Approach

Migrated the validated POC to a production Azure architecture — Azure Functions with TypeScript and a React frontend. Built and led an offshore development team. Rebuilt 50+ serverless functions and React components. Replaced legacy iframe-based lab and prescription ordering with direct API integrations. Built new payment processing integrations. Established HL7/FHIR integration patterns for interoperability. Stood up HIPAA-compliant cloud infrastructure with proper audit logging. Implemented CI/CD pipelines.

Result

Fully modernized EMR platform running on Azure with automated deployments, HL7/FHIR integrations, and a scalable architecture the team could maintain independently. Replaced a legacy Java monolith that had been in service for nearly two decades.

Azure FunctionsTypeScriptReactHL7/FHIRCI/CDPostgreSQL
Challenge

A rough migration from a legacy system into Salesforce left the data in worse shape than before. On top of that, a third-party search platform sold as an AI-powered magic box couldn’t actually find the right candidates. Recruiters hated it. The real problem wasn’t the search engine, it was the data: 80,000+ contact records with unstructured resume data that recruiters had to read manually to extract relevant details.

Approach

Built an AI-powered data cleaning tool using Claude to extract structured details from resumes and populate Salesforce fields. Built a custom Azure-based search solution with meaningful filters, dropdown selectors, and keyword search — the practical tools recruiters actually needed. Integrated directly with Salesforce for seamless workflows.

Result

Replaced a failing search platform with a system recruiters actually use. Cleaned and structured 80,000+ contact records. Recruiters can now find the right candidates in seconds instead of manually reading resumes.

AzureSalesforceAzure Cognitive SearchClaude AIPython.NET
Challenge

Aging digital banking platform serving 130,000+ members with growing compliance risk. Non-compliant legacy systems, no cloud analytics capability, and statement generation costs consuming budget. Board needed a technology strategy they could trust.

Approach

Led enterprise-wide digital banking platform migration with near-zero member disruption. Built a cloud analytics hub on DataBricks, Synapse, and Power BI. Replaced non-compliant legacy systems with .NET Core microservices. Presented the full technology strategy and roadmap to the Board of Directors.

Result

Successful migration for 130K+ members with near-zero disruption. 60% cost reduction in statement generation. Compliant, modern infrastructure with real-time analytics capability.

DataBricksSynapsePower BI.NET CorePCI DSSMicroservices
Challenge

Brought in as employee #5 to repair a broken relationship with the company’s largest customer. The application was built for smaller customers and couldn’t handle enterprise-scale volume — massive timeouts and API failures were destroying the partnership.

Approach

Re-engineered the application for enterprise-scale performance. Took a critical API endpoint from a 30-minute timeout down to under 15 seconds. Stabilized the platform to handle the volume and reliability demands of a major healthcare staffing operation.

Result

Saved the customer relationship. The turnaround directly contributed to the company’s acquisition.

.NETAPI PerformanceSQL OptimizationHealthcare IT
Challenge

Telecom routing costs for toll-free numbers were bleeding millions annually. Routing decisions were static and never revisited, even as carrier rates and call patterns shifted daily.

Approach

Built an ML-driven .NET routing engine that analyzed the previous day’s call data, identified optimal routing changes for toll-free numbers, and executed those changes automatically via carrier APIs. The system re-evaluated performance the next day and continuously refined its decisions — a self-improving optimization loop running without manual intervention.

Result

$2.4M per year in telecom cost savings. Fully automated — no human in the loop for daily routing decisions. Continuous optimization that got smarter over time.

.NETMachine LearningAPI AutomationTelecomData Analytics
Challenge

Saw an opportunity to build a better conferencing platform. Started from scratch with no funding, no customers, and no infrastructure. Had to build everything — the product, the billing system, the team, and the business.

Approach

Co-founded and built an API-driven real-time conferencing platform handling 3,000+ concurrent calls. Built fully automated PCI DSS-compliant billing from scratch — daily credit card processing, decline management, automatic service suspension, and user notifications all running without human intervention. Scaled the team and the customer base through product-led growth. Grew to 10,000+ customers and $9M in revenue.

Result

Acquired by NTT. Stayed on as VP of Information Systems for 6 years, managing a $33M budget and 225+ people across 8 countries.

SaaSReal-time SystemsAPI ArchitecturePCI DSSTelecom
About

Bill Barksdale

I've been doing this for over 20 years. I co-founded AccuConference, grew it to 10,000+ customers, and sold it to NTT. I was VP of Technology at a healthcare workforce startup through its acquisition. Two successful exits. I've managed $33M budgets and teams of 225+ people across 8 countries.

Then I figured out something about myself — I'm not a sit-in-meetings guy. I'm a get-in-the-code, fix-the-architecture, ship-the-thing guy.

I have a pattern: I walk into companies with outdated platforms, mounting technical debt, and teams that need unblocking — and I fix what's wrong. At that healthcare startup, I came in as employee #5, rebuilt the engineering organization to 40+, and helped lead the company to acquisition. At AccuConference, I built the technology from nothing and grew it to an exit. The common thread is taking something that isn't working and making it work.

Now I run a boutique consulting practice, and most of what I do is security work in places where getting it wrong is expensive. A medical device heading into an FDA submission that needs a cybersecurity package. A penetration test report full of findings and nobody who can close them. A breach that needs investigating and an environment that needs rebuilding afterward. Healthcare, medical devices, legal, financial services — regulated industries, where the consequences are real.

I can read the finding, write the fix, and produce documentation that holds up for a regulator — rather than hand you a report and a list of recommendations someone else has to implement. CISSP certified.

I don't sell hours. I sell outcomes. Every engagement has a defined scope, defined milestones, and a fixed price. I assess the problem, I scope the fix, and I deliver it. No open-ended billing, no surprise invoices.

Certifications
›CISSP: Certified Information Systems Security Professional
›AZ-305: Azure Solutions Architect
›AZ-104: Azure Administrator
›AI-900: Azure AI Fundamentals
›Johns Hopkins Healthcare Data Security
›Vanderbilt Agentic AI
›ITIL 4 Foundation
›Certified ScrumMaster (CSM)
Contact

Have a system that needs fixing?

Tell me what's not working. No pitch deck, no sales call — I'll give you straight advice whether we work together or not.

Rather skip the form? bill@bato.com reaches me directly.

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