A treatment delivery system includes one or more medical therapy delivery devices (34) which deliver medical treatment or therapy to a patient, and one or more medical devices (10) which monitor results of the delivered medical therapy or treatment, clinical information, laboratory information, and health record information. The medical treatment delivery device has a proprietary communications protocol. A medical therapy delivery controller (18) semantically communicates among the medical device(s) and one or more medical treatment delivery devices. The controller has a user input (32) by which a user inputs therapy objectives in other than the proprietary communications protocol and a control processor (26) which generates treatment delivery device control commands, receives treatment or therapy results from a medical device (10), and adaptively adjusts the control commands based on the received treatment results. The control processor accesses a clinical decision support system (41), determines a physiological state of the patient from the received treatment results, and adjusts one of the therapy objectives and the control commands in accordance with input from the clinical decision support system.
