# Ryan Yannelli — Full Site Content > Single-fetch ingestion bundle of the long-form content on ryanyannelli.com. Last updated 2026-06-04. Ryan Yannelli is the CTO and co-founder of Nextvisit AI, a healthcare technology company building ambient AI clinical documentation for behavioral health providers. He has been writing software professionally for about 17 years, lives in New York, and is publicly active in the Type 1 Diabetes community as a patient, DIY Loop user, and Breakthrough T1D walker. --- ## About Ryan Yannelli Technologist and founder. Ryan spends most of his days trying to make clinical documentation suck less. ### The early years Ryan started building websites at 12. His first business, in 2009, was tiny and mostly embarrassing in hindsight, but it taught him that technical skills only matter if someone will pay for the thing you made. By 16 he was a network engineer at CSDNET, wiring up infrastructure for hospitals, schools, and a handful of other places that should have known better. Most kids that age were learning to drive. He was learning that when a hospital network goes down at 2am, nobody wants to hear about your weekend plans. ### Technical evolution From 2018 to 2020 Ryan was a professional services engineer at LISS Technologies, running VoIP rollouts, Exchange migrations, and M365 deployments through their nSpeak subsidiary. After that he took over operations: data centers, engineering teams, and the infrastructure underneath a telecom service. His stack has shifted a lot. He started in PHP and JavaScript, picked up TypeScript and Vue.js along the way, and now spends a good chunk of his time on LLMs and speech models. The tools change; the job does not. You still have to understand the problem before the framework can help. ### Building Nextvisit AI In 2021 Ryan teamed up with Dr. Faisal Rafiq, a practicing psychiatrist who had been complaining about documentation for roughly his entire career. They decided to build what Faisal wished existed: software that handles the notes so he could go home at a reasonable hour. Today, Nextvisit helps behavioral health providers cut documentation time by 70% and reclaim a few hours a day. Practices on the platform see about 30% more revenue from same-day billing and noticeably better patient retention. In 2025 Nextvisit joined Jason Calacanis's LAUNCH Accelerator (Cohort LA35) and kept building. ### Living with Type 1 Diabetes In November 2023, at 26, Ryan was diagnosed with Type 1 Diabetes. He was already two years into Nextvisit, and suddenly he was the patient. Building tools for clinicians is one thing. Sitting in the chair on the other side of the desk teaches you something different: how quickly a distracted doctor can miss the thing you actually came in for. Ryan runs DIY Loop with Omnipod and Lyumjev every day. It is open-source diabetes tech built by people who refused to wait for the FDA to catch up, and it quietly keeps him alive. The lesson stuck: people die when they cannot afford insulin. Good healthcare software should give people more life, not just move paperwork faster. ### Philosophy Ryan tries to build things that matter and avoid things that do not. That is harder than it sounds. Most good products come from understanding the user well enough to know when they are wrong, iterating past the version you are proud of, and not mistaking "clever" for "correct." --- ## Frequently Asked Questions **Who is Ryan Yannelli?** Ryan Yannelli is the CTO and co-founder of Nextvisit AI, a healthcare software company that writes clinical notes for behavioral health providers using AI. He has been writing software and running companies for about 17 years, starting with a web design business at age 12. **What is Nextvisit AI?** Nextvisit AI is an ambient AI scribe for behavioral health providers. It listens during patient visits and writes the clinical note as the conversation happens, cutting documentation time by about 70%. Ryan co-founded it in 2021 with psychiatrist Dr. Faisal Rafiq. **What is Ryan Yannelli's background?** Ryan started a web design business at 12, in 2009. By 16 he was a network engineer running infrastructure for hospitals, schools, and other institutions. He spent several years in professional services doing VoIP, Exchange, and M365 work, then ran operations at a telecom company before co-founding Nextvisit AI. **Is Ryan Yannelli involved in Type 1 Diabetes advocacy?** Yes. Ryan was diagnosed with Type 1 Diabetes in November 2023 at age 26. He runs DIY Loop with Omnipod and Lyumjev, walks the Breakthrough T1D Walk in Westchester, and pushes for better insulin access and open diabetes tech. **What technologies does Ryan Yannelli work with?** Ryan works mostly in Laravel, Vue.js, Python, and TypeScript. He has spent plenty of time on AWS, Google Cloud, and Azure, and works with LLMs, speech-to-text, and clinical NLP. On the healthcare side, he is comfortable with HIPAA, SOC 2, and EHR integrations. **What open source projects has Ryan Yannelli contributed to?** Ryan maintains a handful of open-source projects, including Laravel packages on Packagist and machine learning datasets on Hugging Face. One example is the Claim.MD PHP SDK, which handles healthcare claims, eligibility checks, and electronic remittance. **How can I contact Ryan Yannelli?** Email is best: ryanyannelli@gmail.com. He is also on LinkedIn, GitHub, and X (Twitter). --- ## Nextvisit AI Nextvisit AI writes clinical notes for behavioral health providers so they can stop typing and start listening. It is an ambient AI scribe co-founded by Ryan Yannelli and Dr. Faisal Rafiq in 2021. ### Metrics - 70% less time spent on documentation - 3.4 hours back in the clinician's day - 30% revenue lift for practices ### The problem Most providers spend about two hours on documentation for every hour with a patient. That math gets you burnout, shorter visits, and a system that cannot keep up. Nobody went to medical school to catch up on notes after dinner. Nextvisit exists to give clinicians those evenings back. ### The solution Ambient AI that works the way clinicians already do: - **Ambient AI scribe** — Listens during the visit and writes the note as the conversation happens, so clinicians can stay with the patient instead of the keyboard. - **Notes that fit the EHR** — Generates clinical notes in the formats your EHR already expects, so you can drop them in without reformatting. - **Built for behavioral health** — Tuned for psychiatry and addiction treatment, including the vocabulary and note types those specialties actually use. - **AI patient timeline** — Shows the full patient history over time and pulls out patterns that are easy to miss in a 30-minute appointment. ### Founding story Nextvisit started as a conversation in 2021. Ryan met Dr. Faisal Rafiq, a practicing psychiatrist who had been complaining about documentation for about 15 years, and they decided to do something about it. Faisal knew the problem from the inside. He watched colleagues lose weekends to notes. He watched good doctors leave the field, not because they stopped caring about patients, but because the paperwork finally broke them. His own workday did not end when the last patient walked out — it ended at 10pm, when he finally closed the charting tab. Ryan brought 17 years of software work, including a few years running infrastructure inside hospitals. The result is the ambient AI scribe at nextvisit.ai: it listens to the visit, follows the conversation, and produces the clinical note while it is happening. Real SOAP and DAP notes. Proper addiction-treatment documentation. Providers go home on time, bill the same day, and tell us patients feel more heard. ### Recognition - **Best AI Medical Scribe 2025** — Named best AI medical scribe in New York. - **5 stars on G2** — Users consistently give five-star reviews. - **LAUNCH Accelerator (LA35)** — Part of Jason Calacanis's LAUNCH Accelerator, cohort LA35. --- ## Type 1 Diabetes Advocacy Ryan was diagnosed with Type 1 Diabetes in late 2023, already two years into building healthcare software. The work he was doing for clinicians got a lot more personal overnight. ### Living with Type 1 Diabetes November 2023. Ryan was 26. He had been building Nextvisit for two years with the goal of giving clinicians more time with patients. Then he was a patient, and the equation he had been working on from the outside suddenly had him on the inside. Type 1 Diabetes is an autoimmune condition. The immune system decides the insulin-producing cells in your pancreas are the enemy and takes them out. It is not caused by anything you did, and there is no cure yet. In Ryan's case it was triggered by GAD65 antibodies. Management is 24/7: math, testing, and tech that a lot of patients literally need to stay alive. ### The DIY Loop movement Loop is an open-source closed-loop insulin system built by people with diabetes, for people with diabetes. It hooks a continuous glucose monitor up to an insulin pump and adjusts delivery on its own to keep blood sugar in range. Ryan runs Loop daily with Omnipod and Lyumjev. The community built it years before commercial systems got this good. It makes thousands of little decisions a day that no human wants to manage by hand. The rallying cry: **#WeAreNotWaiting**. ### Breakthrough T1D Breakthrough T1D (formerly JDRF) is the biggest organization funding Type 1 research. They have poured billions into the work that got us from daily finger sticks to CGMs and closed-loop pumps, and they are still chasing a cure. Every year Ryan walks the Breakthrough T1D Walk in Westchester with a few thousand other people who know what daily life with T1D actually looks like: the math at every meal, the pump alarms at 3am, the fact that insulin is not optional. People die when they cannot afford the medication keeping them alive. That is not hypothetical. It is why the advocacy part matters as much as the research. --- ## Article: Why I Walk — My Type 1 Diabetes Story *Published 2025-10-01. From ICU at 108 lbs to a 4.9% HbA1c using DIY Loop.* In November 2023, Ryan was admitted to the ICU weighing 108 pounds at 6 feet tall. He was diagnosed with Type 1 Diabetes, with positive GAD65 antibodies and an HbA1c over 15%. He was in severe diabetic ketoacidosis (DKA), had multiple muscle tears, and a hematoma. It started with what felt like a cold. Then it escalated to a severe flu. Ryan left the hospital using a walker, then graduated to a cane, and now can walk just fine again. The muscle tears were caused by the DKA — something he did not know was possible until he lived it. ### The signs were there For 2-3 years leading up to diagnosis, Ryan experienced small symptoms that were dismissed by his prior doctors. Looking back, the signs were there. Type 1 Diabetes in adults often gets missed or misdiagnosed because people assume it only happens to children. It does not. ### Building his own solution Ryan has been building technology for 17 years. When he was hospitalized, he was already two years into building Nextvisit AI. Suddenly, he was the patient. He spent his bedridden days doing what he does best: learning. Reading studies, books, talking with others in the T1D community. His technology background became his advantage. He implemented DIY Loop, an open-source automated insulin delivery system that functions essentially as a bionic pancreas. Using Omnipod and Lyumjev, he has achieved a 4.9% HbA1c and stable vitals. His doctors say he has a low risk of developing complications. ### What Type 1 actually is For people with Type 1, the pancreas does not produce insulin because the immune system attacked the islet cells. No diet, exercise, supplements, or TikTok influencer can cure it. It is not something patients caused. It is not something they can reverse with lifestyle changes. They depend on insulin to stay alive. People die when they cannot afford the medication they need. That is not a hypothetical. It is why this matters. ### Why he walks Ryan has embraced T1D and is using his technical abilities and position in the healthcare space to further advancement for T1D technology. Building Nextvisit taught him that healthcare technology should make lives better, not just processes faster. Living with T1D reinforced that belief from the other side of the exam room. He walks with Team Yannelli at the Breakthrough T1D Walk in Westchester each year. Breakthrough T1D, formerly JDRF, is the leading global organization funding Type 1 Diabetes research. --- ## Article: Nobody fell in love with AI. They fell in love with AI below cost. *Published 2026-06-04. The flat-rate AI era was a subsidy, and the bill is now landing in public.* The thesis: AI went mainstream not only because it was good, but because for about three years the average person used frontier models at a price that had almost nothing to do with what the model cost to run. That subsidy is now ending in public, on pricing pages. ### The subsidy was admitted In January 2025, Sam Altman said OpenAI was losing money on its $200-per-month ChatGPT Pro plan — the most expensive consumer tier did not cover its own compute. In the first half of 2025, OpenAI reportedly brought in about $4.3 billion in revenue while posting a net loss in the billions, with compute as the dominant cost. ### The roll-off is on the pricing pages Developers hit the real cost first because they are the heaviest users on the most expensive agentic workflows: - **Cursor** (June 2025) moved from request-based plans to usage-based credits that deplete at the underlying model's API rate, apologizing publicly that July after surprise charges; effective premium requests on the $20 plan dropped from ~500 to ~225. - **GitHub Copilot** started billing premium requests in June 2025, then moved all plans to fully usage-based, token-metered billing on June 1, 2026 — two structural pricing changes on 4.7 million paid subscribers in under twelve months. - **Anthropic** added weekly rate limits to Claude Pro and Max in August 2025 to rein in continuous Claude Code usage; past the cap you pay standard API rates. Three companies, three mechanics, one identical move: stop pretending compute is free and route the real cost back to whoever generates it. ### Who pays when the price is real Roughly 5% of ChatGPT's 800–900 million weekly users pay for a subscription; Menlo Ventures put the figure for generative AI overall at ~3% of 1.8 billion users. Pull the subsidy and you get a split: a small group keeps paying because the value is obvious, and everyone else drifts to weaker free tiers, ad-supported tiers, or back to the old way. ### What survives full price Use cases where the output has a clear dollar value, usually paid by someone other than the end user: coding, anything billed by the hour, and narrow vertical tools plugged into revenue or compliance. Clinical documentation in healthcare survives full pricing precisely because the practice or payer absorbs the cost. The pricing was a promotional period, and promotional periods end; the open question is which everyday habits people keep once they pay what a query actually costs to serve. Full text: https://ryanyannelli.com/blog/nobody-fell-in-love-with-ai-below-cost/ --- ## Identity & Contact - **Email**: ryanyannelli@gmail.com - **Website**: https://ryanyannelli.com - **Company**: https://nextvisit.ai - **LinkedIn**: https://www.linkedin.com/in/ryanyannelli/ - **GitHub**: https://github.com/yannelli - **X / Twitter**: https://x.com/RyanYannelli - **Bluesky**: https://bsky.app/profile/did:plc:ad4eh25chtmy4jput3vdwk63 - **Hugging Face**: https://huggingface.co/yannelli - **Medium**: https://medium.com/@yannelli - **Substack**: https://yannelli.substack.com - **YouTube**: https://www.youtube.com/channel/UCJnsCnxL3VQjrKxKmoZxOUg - **Location**: New York, USA