The interoperability capabilities of today’s acute care medical devices do not address the current and future needs of clinicians and hospital management. We present a secure and safe architecture based on international standards for medical device interoperability in acute and perioperative care environments that enables the development of vendor-independent Medical Apps. The architecture is based on the combination of IHE PCD profiles with the IEEE 11073 Service oriented Device Connectivity (SDC) standards family for communication ‘from the medical device’s interface’. We provide detailed insight into the interoperability challenges for a silent ICU, as well as an interoperable setup for surgical interventions. We also describe how the envisioned conformance scheme would allow a Hospital to select those medical devices that contribute best to the clinical needs of its staff.