Show HN: An open-source telephony stack for AI voice agents (Twilio alternative) (github.com)

A new open-source telephony stack designed for AI voice agents has been released as a production-ready alternative to Twilio, focusing specifically on HIPAA compliance for healthcare applications. Developed using Asterisk and the AWS Chime SDK, this self-hosted solution offers users complete control over their telephony infrastructure without the prohibitive costs associated with Twilio's HIPAA-compliant services, which can reach up to $2,000 per month. This project includes features like customizable call handling and scalable management of concurrent calls, making it ideal for organizations needing tailored telephony solutions. The system employs a combination of Asterisk for SIP functionality and AWS Chime for handling inbound calls, transforming audio streams via RTP into WebSocket communications that can easily interact with AI voice services, such as those powered by OpenAI. With detailed technical specifications for setup—including Docker-based deployment and ARI (Asterisk REST Interface) management—developers can build and maintain a sophisticated telephony stack that meets their specific compliance needs. This innovation opens new possibilities for healthcare-focused AI applications, enabling enhanced voice interactions while maintaining robust data security standards.