  The integration of medical devices in the patient treatment process becomes
increasingly important due to the efficiency of the technology. On the one
hand, medical devices hardware is more powerful and its integration with the
software platforms is improved. These devices are able to transfer accurate
data to the clinician and offer the possibility of sharing data with other
devices or computational servers for advanced analysis. On the other hand,
medical software platforms are appearing to provide advanced functionality on
top of these medical hardware devices. In this context, the role of the
software is essential, not only at the highest abstraction level that provides
the application business logic; the role of the underlying connecting software
(the communication middleware or distribution software) is essential. These are
capable of providing advanced connectivity functions, very efficiently, and
within appropriate time bounds. This paper reviews the state of the art on
middleware as facilitator for interconnection among devices and also describes
a number of initiatives (such as the Integrated Clinical Environment -ICE) and
projects that further extend the underlying distribution software towards the
clinical domain as device interconnection facilitators.
