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One of the main challenges to be confronted by modern health care, so as to increase treatment quality, is the personalization of treatment. The treatment personalization requires the continuous reconfiguration and adaptation of the selected treatment schemes according to the “current” clinical status of each patient and “current” circumstances inside a health care organization that change rapidly, as well as the updated medical knowledge. In this paper, we present an innovative software environment that provides an integrated IT solution concerning the adaptation of health care processes (clinical pathways) during execution time. The software comprises a health care process execution engine assisted by a semantic infrastructure for reconfiguring the clinical pathways. During the execution of clinical pathways, the system reasons over the rules and reconfigures the next steps of the treatment. A graphical designer interface is implemented for the definition of the rule-set for the clinical pathways adaptation in a user-friendly way.