Smart Devices: Science Fiction or Reality

I've always been baffled at the level of integration found between medical devices and healthcare information systems when concerning the way humans interact with the two. Exceptional integration exists to connect medical devices to healthcare information systems, especially in the critical care arena. Likewise, equally exceptional analysis tools exist to analyze data collected into systems. However, the very existence of these solutions seems to only the scrape the surface. I tend to believe many would agree that further integration is paramount, and even expected on a much larger scale. 

In practice the execution of such integration often leaves much to be desired when 21st century technology is considered. Interfaces between devices and systems are typically designed only to take value X from system A and place it in field Y of system B. Beyond that, little else occurs from an integration perspective unless expressly required for the solution to complete a specific clinical task. What could be done to further integrate a solution?