When the Average Misleads: Heart Rate Variability from Mean Heart Rate to Autonomic Dynamics

Vintage medical illustration of an early 20th-century doctor studying an electrocardiograph displaying a mix of normal ECG waveforms and surreal, distorted heart rhythm patterns beside a patient in a hospital bed.

Mean heart rate is one of the most familiar numbers in medicine. Useful, immediate, and often enough for a first description. Yet every average carries the same defect: it compresses into a single value everything that happened over time. Two patients can share a mean of 70 beats per minute (bpm) and, across the same … Read more

From Chart to Variable: Extracting Computable Clinical Features from the EHR

Early 20th-century doctor looks perplexed at a bedside table crowded with medicine vials and bottles in an old hospital ward.

Vasoactive-Inotropic Score as a Worked Example Introduction: The Data Is There. The Variable Is Not. Every conversation about clinical AI opens on the same premise: hospitals are sitting on enormous quantities of data. True enough, and almost useless as a starting point. An electronic health record is a transactional system, built for documentation, for billing, … Read more

Multi‑Agent AI in Healthcare

small “town band” made of poorly dressed boys plays using improvised instruments

From passive Q&A to autonomous agents that debate, challenge, and assist clinicians. Article authored by Michele D. Pierri, MD Cardiac Surgeon & Medical Technology Researcher Last updated: June 2026 Reading time: 15 minutes Key takeaways 1. Redefining AI in Medicine: What Is an Agentic System? The first wave of AI in healthcare gave us chatbots. … Read more

Why Clinical Digitalization Fails: A Structural Mismatch Between Medicine and Software

Early 20th-century doctor reading beside a large mechanical records machine in a sunlit hospital ward, as long handwritten paper scrolls curl above rows of iron beds and arched windows

Healthcare systems across the world have invested billions in clinical digitalization. Electronic health records (EHRs), clinical data warehouses, integrated hospital platforms, and now artificial intelligence systems have been introduced under the promise of efficiency, transparency, interoperability, and improved patient outcomes. Yet, after more than two decades of implementation, the recurring pattern remains strikingly consistent: resistance … Read more