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.