Pipecat has been instrumental for us at Pear - we use AI communication to communicate with patients. We started using pipecat before pipecat cloud was a thing; they haven't stopped showing love to their open source repo in spite of the cloud product (it helps that the cloud product is also powered by the open source code). We have had no issues, even when we had to switch providers – fortunately pipecat provides integrations with all major players in the space. Their docs are great and customer service is the best. I have been on video calls with their CTO at midnight multiple times, and have always left with a satisfactory result.