Adrian Rossouw — AI engineering & regulated-industry delivery

I have been writing software since 2000, and working remotely since 2004, two decades of distributed work before it had a name or a handbook. That arc runs from South Africa, through twenty years of open-source work with North American companies, to Dublin.

For the last five years I led the technology organisation at Renalytix, behind KidneyIntelX.dkd, an AI-enabled diagnostic that earned FDA De Novo authorization. That meant building and running a software group under ISO 13485 and ISO 27001, shipping more than ten EHR integrations into major US health systems, and owning the architecture beneath a submission I contributed to rather than led.

Before that, nearly seven years at NearForm as Delivery Architect and then Technical Director. I was the first technical person on a client engagement, picking it up the moment sales handed it over and carrying it through discovery, prototyping, architecture, and delivery to production. Forward-deployed work by another name.

These days I spend most of my time hands-on with agentic AI, where it meets the regulated-software world I've worked in. Early and open-ended, kept in public at formicary.ai.

The through-line across 25 years: open-source roots, a long run of building and leading remote teams across time zones, and a soft spot for making complex systems boring and dependable.

Practice

What I do well.

01 Build and ship software in regulated settings: medtech, fintech, compliance-heavy SaaS.
02 Design and run AI and agentic systems where getting it wrong has real consequences.
03 Stand up engineering organisations that pass audits, not just demos.
04 Own delivery from the first technical engagement through to production hand-off.
05 Translate between engineering and executive, clinical, and regulatory audiences.

Work

A handful of things I've worked on.

Twenty-five years of work compressed, ruthlessly, into four entries.

01

KidneyIntelX.dkd

Renalytix / VP Information Systems & Product / 2020 – present

FDA De Novo-authorized AI diagnostic for kidney disease.

Led the technology teams behind an AI diagnostic that predicts kidney function decline in diabetic patients with early-stage kidney disease. Provided architectural direction through the FDA De Novo submission, built out a SaMD-classified engineering organisation under ISO 13485 and ISO 27001, and shipped production EHR integrations into health systems including Mount Sinai and Singing River, across Epic, eClinicalWorks, and athenahealth. Much of what I learned here is specific to regulated AI: change control, validation, clinical partnership, and the pace at which you can ship when a bug has patient consequences.

FDA ISO 13485 ISO 27001 SaMD EHR
02

Enterprise delivery portfolio

NearForm / Delivery Architect → Technical Director / 2015 – 2021

Node.js consulting at enterprise scale, end-to-end.

As Delivery Architect and then Technical Director at a large remote-first Node.js consultancy, I was the first technical person on an engagement once sales handed over a hot lead, and I owned it from there: discovery, architecture, delivery, and the client relationship through to production. Projects ran across a global ethics and compliance investigation product, DevOps and build pipelines for a payroll firm running hundreds of developers across dozens of services, a course-management and CBT system for a global consulting firm, and a cash-distribution optimisation system deployed across banks and ATM networks in Africa and Asia. I also ran the company's open-source portfolio for a year.

Node.js microservices consulting team leadership
03

Aegir Hosting System

Development Seed · open source / Founder & lead developer / 2007 – 2011

Turn-key hosting platform for Drupal sites.

Founded and led the first major version of Aegir, an open-source turn-key hosting platform for Drupal. It took a familiar pain point, managing hundreds of Drupal installs, and made it boring, which is the highest compliment infrastructure can receive. The project outlived my involvement by years, which remains the thing I am most quietly pleased about.

open source Drupal PaaS infrastructure
04

Early MapBox-era work

Development Seed / Senior Developer / 2009 – 2012

Data-oriented sites on the open-source mapping stack.

At Development Seed I moved to Node.js alongside the team and contributed to a run of large data-oriented sites and applications. Much of the work sat on an open-source mapping stack that was later spun out as MapBox. I was a contributor, not the architect, and that is a fair reminder that the useful work is often the work you do before anyone has named the category.

Node.js geodata open source

Career

The whole arc.

Johannesburg → Cape Town → Dublin, in roughly that order.

2023 – present VP Information Systems & ProductRenalytix Dublin
2021 – 2023 VP Digital Health Technology DeliveryRenalytix Dublin
2020 – 2021 Head of Health Technology DeliveryRenalytix Dublin
2020 – 2021 Technical DirectorNearForm Dublin
2015 – 2020 Delivery ArchitectNearForm Ireland
2014 CTOWayfinder remote
2012 – 2014 Lead Software ArchitectGoBe.Me remote
2009 – 2012 Senior DeveloperDevelopment Seed remote
2004 – 2009 Developer, co-founderBryght / Raincity Studios remote
2001 – 2004 Application DeveloperObsidian Systems South Africa
2000 – 2001 Instructor, then DeveloperITTC Pretoria

Contact

Write to me.

I'm in the middle of a digital purge, moving off old platforms and scaling back my public presence. Possibly to the detriment of my career, certainly to the benefit of my sanity.

LinkedIn is the most reliable place to reach me. If we've met and you have my email, use it.

adrianrossouw

GitHub

AdrianRossouw

I work at the seam between AI engineering and regulated‑industry delivery.

What I do well.

A handful of things I've worked on.

KidneyIntelX.dkd

Enterprise delivery portfolio

Aegir Hosting System

Early MapBox-era work

The whole arc.

Write to me.