In a multi-tier patient monitoring data analysis system, an algorithm server is positioned as a middle tier between an acquisition device, such as a cardiograph or patient monitor that can be seen as a lower tier, and a storage device for a database, such as that of a central computer for a hospital or clinic that can be seen as an upper tier. The algorithm server gathers current data from the real time acquisition device and obtains previously stored ECG signal data from the database. The algorithm server contains ECG analysis algorithm(s) and runs one or more algorithms using the current and previously acquired ECG signal data. Analysis algorithms may also be run on the acquisition device. The system provides the rapid, extensive, and thorough ECG analysis that is critical to patient welfare.