A clinical therapy system (10) includes a drug delivery device (14) configured to delivery medication to a patient. One or more therapy devices (12, 16, 11, 13, 15, 17) are configured to provide therapy or to monitor the patient. A computer (70) is programmed to perform a CDS method (100) including: receiving clinical context data for the patient from a health information system (HIS) (18); receiving high fidelity data (20, 22, 24, 60, 62, 64, 66) comprising real time measurements for the patient from one or more of the drug delivery device, one or more vital sign sensors, and at least one device of the one or more therapy devices; applying one or more physiologic models (30, 32, 34 36, 38) to the combination of the clinical context data and the high fidelity data to generate a clinical prediction for the patient; outputting a therapy recommendation for the patient based on the clinical prediction for the patient; and controlling operation of the drug delivery device or one of the therapy devices based on the therapy recommendation.