Jeff Carr · 2Meter Partners
Companies are investing heavily in AI, but their ability to effectively operate is not keeping pace. The gap between investment and value is an operations challenge. Operational debt, be it processes that don’t scale, ambiguity around decision rights or accountability, and/or a general lack of rigor is a byproduct of growth and has been papered over with people. Agentic AI exposes these operational debts because undefined processes can’t be automated. I help companies close the gap between investment and value by bringing an operating playbook for organizations making the shift to agentic. Get in touch if you’re interested in learning more about this advisory.
Operating Executive for the Agentic Shift
Get in touchAs a former CEO of a venture-backed company through exit, CTO of a >$1B telecom, Chief Innovation Officer of a large multi-hospital health system, and managing director at a global consultancy, I first witnessed in healthcare what happens when operational debt exceeds an organization’s ability to operate.
01 / The thesis
Technical debt is the consequence of shortcuts, skipped steps and assumptions taken in building software to get it out the door. Technical debt is well understood and accepted.
And then there’s operational debt. The debt that builds up over time as a result of gaps in an operating model: a process that has no owner; an edge case that no one thinks through; an exception that’s handled manually. Operational debt is harder to quantify, manage, track, measure, understand. Which makes it easier to ignore. Which means many organizations don’t track it. Which means most don’t want to admit they have it. Which means that debt stays hidden and grows.
Many organizations have leaned on the efforts of their smartest employees to fill in the blanks and close gaps with personal effort and intellect. Enter agent-building, though. All of those processes have to be made explicit. Those gaps have to be filled. Those blanks have to be closed. Otherwise, the agents break on day one, in an embarrassing and expensive way. Except, of course, no one anticipates that’s going to happen. And yet, those gaps and blanks would’ve surfaced during diligence if any of those organizations had been acquired by someone else.
As a result, AI-enabled organizations will spend tons of money on AI and receive next-to-none back. And when the agents break, the post-mortem meeting will include lots of finger-pointing at the model vendor(s) and the technology. Technology failure. Not yours.
02 / How I help
Across different industries and even within technology itself there are patterns I see time and time again: decisions about technology and technical matters that should have been made earlier have been put off; competitive position is not optimal; technical estates have grown to the extent they are unmanageable.
In all of these areas, what was not addressed in times of relative calm becomes critical in transactions. Examples include diligence of targets, true-ups of integration costs, Day 1 planning, carve-out/separation service agreements and ensuring that an estate is going to deliver against deal assumptions.
See the workThere are situations in which it makes sense to fill a leadership position on an acting basis and/or with a remit that may differ from that of the role. My most recent fractional role was Chief Transformation Officer for a growth-equity-backed platform. Often, resetting technology leadership means changing operating model, spend, vendor relationships and untangling estates that have grown beyond their original intent. In a role like this, the mark of success is leaving behind a stronger and better-positioned organization for the next person to build on.
See the workEverybody has ideas about AI; few have a strategy for what they should and shouldn't automate or generate; how to govern outputs; how to determine success. Often the least popular, but probably most valuable, service I provide in this area is telling them what they shouldn't do.
See the workA lot of my clients have been investor-backed - private-equity-owned companies in deal and strategy work, a growth-equity-backed platform where I was fractional Chief Transformation Officer. I work for the company, not the fund. If you'd like to learn more, you can reach me here.
Also, 2Meter gives you access to my credible, experienced, 25-year network of operators and SMEs to engage for specific assignments.
03 / The method
Find the operational debt - the process, ownership and discipline being absorbed manually.
Write down the process, the owner and the decision rights, so there is something real to automate.
Decide what to automate, and what not to yet - then put agents and systems only on work that is defined and governed.
04 / Proof
Annual cost-out at a >$1B telecom, without degrading service.
Unproductive technology spend eliminated at an energy data-services platform.
Led IT DD of an acquisition target for a healthcare-technology company looking to buy vs. build. Assessed the target’s current state against the product-suite strategy we built first.
Engagement lead for IT separation office for a proposed divestiture at a global pharma company. Scope of work included Day 1 to Month 3 functional IT separation roadmap, management and vetting of TSA-related information provided to bidders. Separation workstream deliverables were successfully completed before the divestiture decision was reversed with assets remaining with the global pharma client.
Co-led the IT and Internet integration of a large telecom acquisition. Applied learnings and best practices from this engagement to an M&A IT integration methodology subsequently developed and used throughout my tenure at a large global industrial company.
Advised PE-owned companies on technology issues affecting the business, at IT-leadership or C-suite level. Topics included M&A, growth strategy and the technology agenda.
CTO of a >$1B telecom: owned network, IT (~$150M spend) and product delivery across Consumer, Commercial and Carrier, with an organization of ~1,000. Drove $50M+ in annual cost-out without degrading service.
Fractional Chief Transformation Officer at a growth-equity-backed energy data-services platform (June 2023 to September 2024): led the transformation, eliminated $10M+ in unproductive technology spend and sequenced further reductions beyond the engagement.
Designed vendor-neutral orchestration platform for radiology AI models (2025 to January 2026) for regional radiology and imaging services business, including market/GTM landscape assessment and value case development (RVU lift and cost-per-case based). Though slated to take on CEO role to drive this new business, after careful consideration determined platform was not the correct decision for the business. Co-led initiative with practice leadership to migrate imaging studies and reading operations to an AI-enabled cloud-based reading platform - the pilot began with the highest-backlog studies.
Demoed solution built on general-purpose model to solve for customer’s challenge with real customer data in 2024, solution demonstrated ~90% of targeted performance. Recommended not to move forward with solution as the last mile of challenges were driven by data access challenges, not model challenges - solving for remaining performance gap would have required a much more deterministic solution.
Built out value-stream based opportunity portfolio and prioritization process to identify and prioritize $500M+ of opportunities for a large healthcare client.
Founder, 2Meter Partners.
Highlights from about 25 years as a technology and health exec across a number of roles including CEO (venture-backed to exit), CTO, Chief Innovation Officer, and other roles including:
Led two exits as a principal - Singlepipe, where I joined as COO and was elevated to CEO, sold into a PE-backed strategic acquirer through the financial crisis with near-full investor capital recovered; and Intelemage, which I co-founded and we sold to Medidata (NASDAQ: MDSO).
Led network, IT (about $150M in spend), and product teams delivering solutions to Consumer, Commercial, and Carrier business units (about 1,000 people). Achieved cost savings in excess of $50M/yr while maintaining service levels. Co-founded Zoomtown and led buildout of its entire network, which was one of the first ADSL deployments in the country, then repeated the feat using fiber for Cincinnati Bell.
Launched a $50M venture fund and holding for-profit entity to make early-stage investments. Built out governance and diligence processes the system kept using after I left. First investment made in 8 months. Investments include 2 direct, 2 fund investments, and equity in a studio for building solutions.
Led multiple large transformational programs (patient access, operating-model), technology DD and strategy engagements.
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