FORM2
THE PATENTS ACT, 1970
(39 of 1970)
&
The Patents Rules, 2003
COMPLETE SPECIFICATION
(See section 10; rule 13)
1. TITLE OF THE INVENTION - MULTI DISPLAY CENTRAL CARE-GIVER STATION WITH PHYSIOLOGICAL PARAMETERS ACQUISITION METHOD
2. APPLICANT(S)

(a) NAME : LARSEN & TOUBRO LIMITED
(b) NATIONALITY: An Indian Company.
(c) ADDRESS: L & T House, Ballard Estate, Mumbai 400 001,
State of Maharashtra, India
3. PREAMBLE TO THE DESCRIPTION
The following specification particularly describes the invention and the manner in which it is to be performed:

FIELD OF THE INVENTION
The present invention relates to a central nursing station or care system and method adapted for the central monitoring patients to determine the various physiological parameters/vital signs. Particularly, the present invention relates to an improved multi display station/system with WI-FI enabled 12 lead ECG acquisition machine/patient monitor . More particularly, the present invention is concerned about a method adapted to determine, analyze, acquire and get protected review of the various physiological parameters/data of multiple beds over the wireless network and display them in the multi display system simultaneously.
BACKGROUND AND PRIOR ART OF THE INVENTION
US 2010/0298657 discloses a body-worn monitor that measures a patient's vital signs (e.g. blood pressure, Sp02, heart rate, respiratory rate, and temperature) while simultaneously characterizing their activity state (e.g. resting, walking, convulsing, falling). The body-worn monitor processes this information to minimize corruption of the vital signs by motion-related artifacts. A software framework generates alarms/alerts based on threshold values that are either preset or determined in real time. The framework additionally includes a series of "heuristic' rules that take the patient's activity state and motion into account, and process the vital signs accordingly. These rules, for example, indicate that a walking patient is likely breathing and has a regular heart rate, even if their motion-corrupted vital signs suggest otherwise.
US '657 is concentrated on mobility of the patient and only filtering of ECG signal is disclosed. It does not suggests anything about ST segment analysis , acquiring Invasive blood pressure , Drug calculation parameters, clinical body temperature, non-invasive blood pressure, Oxygen saturation, pulse , heart rate, Concentration of the anesthesia gas administered to the patient etc.
US 2010/0274098 discloses a patient monitoring system is disclosed having a central configuration management system in communication with a plurality of medical monitors via a communication system. The central communication management system allows users to create a plurality of use-specific monitor configurations, such as physician-specific and location-specific monitor configurations. The plurality of use-specific monitor configurations is stored on the

central communication management system until a use-specific monitor configuration is selected
for a particular monitor.
US '098 does not explains about 12 lead electrocardiograph with ST segment analysis and acquiring it and reviewing over the wireless network to a central station and analyzing it along with other relevant vital signs. The prior art does not teaches anything about acquiring the signal over mobile phone. Also protection of patient information by providing password and username is not there in this prior art. The sending of SMS as well as MMS to the user through mobile phone is not taught.
US 2006/0287586 discloses a system for medically monitoring a plurality of patients, includes a plurality of medical monitors, each monitor having at least two medical sensors for sensing medical data of a patient, a display for displaying sensed medical data, a wireless transceiver, and processor for processing the sensed medical data and for controlling the operation of at least the display and transceiver. The monitors are arranged to form a short range wireless local area network in which at least one of the monitors is arranged to display not only the medical data sensed by its sensors but also the medical data sensed by the sensors of any other medical monitor in the local area network. The at least one of the monitors has a further wireless transceiver operable to receive the medical data from the local area network and transmit it to a location outside the said local area network.
US '586 does not teach about Graphical and Tabular trend with maximum 1 min resolution (By default limited to 1 Month). Further it does not teach about selection of user to select Alarm recall with filter for arrhythmia where alarm review for 30 sec is provided and waveform review is provided for 72 hrs.. It does not disclose anything about the user shall be able to select 1 min waveform for displaying Scalable monitoring capability 1-n beds Trend Data with full disclosure viewing over LAN or a WAN. In the present case when WAN is used, VPN can be configured.
US 20090054743 discloses a novel method of generating and representing the status of various physiological parameters that are monitored for patients during hospitalization. The system of

present invention allows healthcare providers to easily view, at a glance, the status or trend of a patient or a plurality of patients as well as any changes in the parameter values.
US '743 discloses about trending physiological signals. It does not teach data and web configuration and administration management functions, that includes registering/un-registering acquisition servers, client state data, logs, data backup/restore.
In the present invention web viewer can only display the stored waveform and parameter trend data of a bed/patient. It can be accessed from any system that has Internet Explore application including the mobile devices.
US 6,544,174 discloses a wireless patient monitor is adapted to communicate with any one of plural medical telemetry networks, each having one or more central stations, where each network is configured to communicate via wireless communications using one of multiple different communications settings. The monitor includes one or more sensor inputs for receiving vital signs data from a patient, a wireless transceiver; and a controller coupled to receive the vital signs data via the one or more sensor inputs and to communicate with a network via the transceiver. The monitor also includes a display device and is controllable by the controller to automatically display a notification to a user of the monitor upon establishing communications with the at least one central station. There is also a method of monitoring a patient and a wireless medical telemetry system.
US '174 discloses a wireless patient monitor and CNS. It does not disclose how the data is acquired, protected reviewed and displayed.
WO 2005114524 discloses a system running a Sensitron Personalization Protocol (SPP) for automated, efficient, or cost effective remote medical monitoring of patients located in hospitals, healthcare institutions or homes. The system is a modular and automated system, scalable to support very large number of users reliably, wireless enabled medical monitors with two way communication between server for real time data transfer, which improves the quality of care, fully automated data collection methodology including the ability to gather data from any medical device with digital data output, communicating with varied protocols, to verify the data

validity or accuracy, insuring data security or confidentiality during data transmission or storage,; or a central server to review the data or make decision in real time including network diagnostic abilities to check the system functionality, data storage with full back up provision or finally, or monitoring stations (wired or wireless) to review patient data.
WO '524 does not give any idea about multibed format, multipara, trend, recall. The local viewer will handle the different configurations and settings that can be accessed by the user. The settings like user selectable waveforms and digital parameters, regional settings, CNS settings are handled solely by the viewer in the present invention
The local database does not handle the raw waveform, does not sorts and stores in different formats for various trends and recall window.
Thus there is a need to provide a system with dual display with a WI-FI enabled 12 lead ECG acquisition machine and review and diagnostics of data. The second display used for displaying the multi-Para, graphical and tabular trend, waveform review, alarm recall, arrhythmia recall, 12L EGC acquisition.
Further there is a need to provide a system in which general data can be viewed by everyone, protected patient data by admin and only assigned patients data is possible to use and where the power users is having access to all the data. A single user can not open simultaneous sessions where the previous login is closed automatically. If the user logs in through a different IP then the older session will be closed after 20 minutes.
More particularly there is a need to provide a system and a method where the cardiac signals which are extracted from patient are stored in ECG machine are then acquired either through wired network or wireless network to the central monitoring station along with other vital signs.
In the present invention the data is sorted and prepared for graphical, tabular trend, alarm recall, arrhythmia recall and 12-Lead ECG recall . The converted data is directly sent to the local viewer for display. The acquisition server, local viewer and the local database together form the
present system.

The present inventors have found that the present system can transfer up to 16 bed real-time waveform from and digital parameter data periodically to the requested client viewer via information server using intranet or internet part through www. Likewise n-number of CNS can be connected to an information server and n-number of clients can be serviced in real-time. The scenario is quite similar to a live (real-time) video or audio web-cast over internet, but with predicated reliability.
The present invention has a CNS remote viewer which are connected through hospital medical grade networks and also connected to the hospital information system and PACS (picture archiving and communications system) with unlimited concurrent users up to one thousand, logging in and using.
OBJECTS OF THE INVENTION
One object of the present invention is to overcome the disadvantages / drawbacks of the prior art.
A basic object of the present invention is to provide a multi display care station/system with WI-FI enabled 12 lead ECG acquisition machine and thus linking of 12 lead ECG data to the system.
Another object of the present invention is to provide waveform review of ECG- Waveform strip view for the time gap of 60 seconds in the multi display care station/system.
Another object of the present invention is to provide a dual display care station/system with simultaneous view of 16 beds in first display and synchronized graphical and tabular trend.
Yet another object of the present invention is to provide Multibed view in first display and elaborated views in second display Viz. Trend, Alarm review, Arrhythmia review , 12 lead ECG acquisition and review.

Yet another object of the present invention is to provide a method to determine from patient Invasive blood pressure, Drug calculation parameters, clinical body temperature, non-invasive blood pressure, Oxygen saturation, pulse, heart rate or any other physiological parameter.
These and other advantages of the present invention will become readily apparent from the following detailed description taken in conjunction with the accompanying drawings.
SUMMARY OF THE INVENTION
The following presents a simplified summary of the invention in order to provide a basic
understanding of some aspects of the invention. This summary is not an extensive overview of
the present invention. It is not intended to identify the key/critical elements of the invention or to
delineate the scope of the invention. Its sole purpose is to present some concept of the invention
is a simplified form as a prelude to a more detailed description of the invention presented later.
According to one of the aspect of the present invention there is provided a A central nursing
station/ system to determine the various physiological paramaters / vital signs of patients, said
system comprising :
plurality of patient monitor means , said each patient monior display comprises monitor network
means;
plurality of display means operatively connected with said patient monitor display means to
display scalable various physiological parameters of various patients ;
plurality of data network means opreatively connected with said plurality display means ; a
central server means operatively connected with said data network means adpated to store the
data/information of said plurality of patient monitor means;
pluarlity of hospital information system and PACS operaively connected with said central server
means via a hub means to provide information/data to said server means; and
plurality of client means located remotely and connected with said storage means via the
internet.

According to another aspect of the present invention there is provided a method to determine, analyze, acquire and get protected review of the various physiological parameters/data of various patients , said method comprising steps of: selecting display in multi-bed view of a central nursing station/system;
selecting a 12 lead ECG acquisition/patient monitor;
selecting display in multi-para mode;
selecting lead configuration, gain, filter and thermal paper motor speed;
enabling or disabling the Pacer pulses generated from pacer implanted patient which are sharp rectangular pulses also QRS beep sounds;
selecting Auto command either from ECG machine or from display (102) or (104) and the signal monitoring starts;
generating a report from the ECG machine and prompt the CPU (106) that it is ready;
generating report using thermal printer by the ECG machine (112) when caregiver selects the 'print' key on board (112) or from display (102) / (104);
linking the records of ECG report with other vital signs generated by Bed side PMS connected to the same patient to whom ECG machine (112) is connected.;
entering the unique" Bed Identification number", Date time and the stored waveform and data ;
upon receiving the consent from caregiver the information is sent to Part (106) and is awaited for further processing.

DETAILED DESCRIPTION OF THE INVENTION
The present invention relates to a central nursing station or care system and method adapted for the central monitoring patients to determine the various physiological parameters/vital signs.
According to the first embodiment of the present invention there is provided a central nursing station/ system to determine the various physiological paramaters / vital signs of patients. The system comprising plurality of patient monitor means, the each patient monior display comprises monitor network means; plurality of display means operatively connected with the patient monitor display means to display scalable various physiological parameters of various patients ; plurality of data network means opreatively connected with the plurality of display means ; a central server means operatively connected with the data network means adpated to store the data/information of the plurality of patient monitor means; pluarlity of hospital information system and PACS (picture archiving and communications system) operaively connected with the central server means via a hub means to provide information/data to the server means and plurality of client means located remotely and connected with the storage means via the internet.
The central server means ( part 216) comprises an acquisition server adpated to acquire the waveform and numerical data from the patient monitors and the raw data acquired is sent to the dual display means for display/presentation; a local database means connetced with the acquisition server to store the acquired waveform and numerical data from the patient monitors and the raw data and a remote data center means/ sender means operatively connected with the local database and the acquisition server.
The local database ( inside skyline part 106 ) handles the raw waveform, sorts and stores in different formats for various trends and recall window and the data is sorted and prepared for graphical, tabular trend, alarm recall, arrhythmia recall and 12-Lead ECG recall and the converted data is directly sent to the display means for display.

The plurality display means comprises a pair of display means, the each display means adapted to display pluralit of patient bed details displaying physiologial parameters.
The remote data center agent (inside part 216 ) means/ sender means operatively connected with a data center means adapted to packetize the data from each cenral nursing station system .
The data center means cormpsies a remote receiver means/ data center acquisition agent operatively connected with plurality of cenral nursing station adapted to receive data from plurality of remote data center agent /sender means all the remote data center adpated for the data traffic management between the database server PC ( part 216 ) and the CNS systems; a data base server means operatively connected with the remote receiver means/ data center acquisition agent ; a data center configuration operatively connected with the data base server means adapted for data preparation for the various types of clients who are logged on and also handles the configuration of the clients and stores the Settings of the clients, Data and web configuration and administration management functions, that includes registering/un-registering acquisition servers, client state data, logs, data backup/restore ; a storage means operatively connected with the data center confguration adapted for proper storage of the CNS data and the storage of the data happens in a more structured manner and a server portal and log in means operatively connected with the storage means.
According to the second embodiment of the present invention there is provided A method to determine, analyze, acquire and get protected review of the various physiological parameters/data of various patients, the method comprising steps of: selecting display in multi-bed view of a central nursing station/system; selecting a 12 lead ECG acquisition/patient monitor; selecting display in multi-para mode; selecting lead configuration, gain, filter and thermal paper motor speed; enabling or disabling the Pacer pulses generated from pacer implanted patient which are sharp rectangular pulses also QRS beep sounds; selecting Auto command either from ECG machine or from display and the signal monitoring starts; generating a report from the ECG machine and prompt the CPU that it is ready; generating report using thermal printer by the ECG machine when caregiver selects the 'print' key on board or from display ;linking the records of ECG report with other vital signs generated by Bed side PMS

connected to the same patient to whom ECG machine is connected; entering the unique" Bed Identification number", Date time and the stored waveform and data ; upon receiving the consent from caregiver the information is sent to and is awaited for further processing.
BRIEF DESCRIPTION OF THE ACCOMPANYING DRAWING
Other features as well as the advantages of the invention will be clear from the following
description.
In the appended drawing:
Figure 1 illustrates dual display with 12 lead ECG acquisition - overall view. Figure 2 illustrates architectural view.
Figure 3 illustrates the major blocks of the client-server with data base server. Figure 4 illustrates detailed flow chart view of 12 lead ECG acquisition. Figure 5 illustrates detailed flow chart view for 12 lead ECG review.
DETIALED DESCRIPTION OF THE ACCOMPANYING DRAWING
In the following detailed description, reference is made to the accompanying drawings that form a part hereof, and illustrate the best mode presently contemplated for carrying out the invention. Further functioning of the system and method has been discussed below to describe the way the mechanism operates. However, such description should not be considered as any limitation of scope of the present system. The structure thus conceived is susceptible of numerous modifications and variations, all the details may furthermore be replaced with elements having technical equivalence. In practice the materials and dimensions may be any according to the requirements, which will still be comprised within its true spirit.
The present invention relates to a new central nursing station/system (CNS) capable of utilizing two monitors for better presentations of the product features. The dual screen has configurable display schemes. It has dual 8 beds. This invention provides the user a 16 bed CNS facility with the features spaced over two displays.

Figure 1, part (100) gives the overall view of the dual display care station with a Wi-Fi enabled 12 lead ECG acquisition machine (112). Part (114) is an electrical connector mounted on (112). The 12 lead Electro cardio graphic signal acquisition cable is connected to the (114) and the other end is connected to the human body for observing electrical activity of the heart.
The first display (102) present the multi-bed view. The second display (104) is used for displaying the multi-para, graphical and tabular trend, waveform review, alarm recall, arrhythmia recall, 12L ECG Acquisition and 12L ECG Review of the bed selected from the multi-bed view.
The Dual display application is launched when two displays are connected to the CPU (106) where it is installed. At the launch of the application, the 16 bed CNS setup is divided into two halves, i.e. 1-8 and 9-16 beds and is presented in two displays (102) and (104). The magnified view of the beds 1-8 is as presented in (120). The magnified view of the beds 9-16 is as shown in
(122).
Part (108) is a Wi-Fi - wireless communication card which is either embedded in the motherboard of the CPU (106) or a add on card. Part (116) is a keyboard and (118) is a mouse used by caregiver to enter the data and for navigating on the display (102) and (104).
The title bar (180) in the '8+8 bed mode' will have word "Skyline55" in the left most side of the first display, date and time (126) on the right most side of the second display (122).
Double clicking on any of the bed icons (178) and (124) before admitting the patient to that bed throws a dialog box containing the message "Please admit the patient to view the Multipara display mode. Do you want to register now?" Clicking on 'Yes' opens the 'Admit Window' 128 or 176 in that display (i.e. 1st or 2nd display) where the bed is located. Clicking on 'No' closes the dialog box. Single clicking on any of the bed before admitting the patient has no reaction from the system. Single or double clicking on any one of the bed before any patient monitor is assigned to that bed from the 'System configuration window' gives a wrong beep.
The rubber key pad / menu bar of the multibed (8+8 bed mode) is as follows:
Display (174), Admit/Discharge (172), Settings (170), Mute (168), Alarm List (166), Shutdown
(164).

Clicking on 'Display' show a drop down menu containing the following:
Multipara (162),Multibed format 1 (160), Multibed format 2 (158)/Trend (156),Alarm recall (154),Arrhythmia recall (152),Waveform Review (150),12 Lead ECG acquisition (148), 12 Lead ECG Review (148).
Clicking on 'Multipara' shows a drop down menu containing the following: Group 1 (146) and
Group 2 (146).
Clicking on the 'Groupl' lists down the beds from 1 to 8 (144).
Clicking on the Group 2 lists down the beds from 9 to 16 (142).
Clicking on any of the beds (178) or (124) opens the Multipara and Graphical Trend of that bed
in the second display. Multipara is placed on the first half and Graphical trend (140) in the
second half.
Clicking on any of the beds in the list as before admitting a patient in that bed throws a dialog box containing the message "Please admit the patient to view the Multipara display mode. Do you want to register now?". Clicking on 'Yes' opens the 'Admit Window' (176) , (128) in that display (i.e. 1st or 2nd display) where the bed is located. Clicking on 'No' closes the dialog box.
Figure 2 discloses the architectural overview of the entire system is, part (200). Parts (202) are several patient monitors having monitor network capability (204). These are connected to CNS data network and hub part (206). The part of the invention disclosed in Fig 1, Part 100 sits in the middle of part (200) as shown in fig 2.
Part (218) is network hub for CNS data network. Part (216) is centralized storage server where the information acquired from various patient monitors (202) is stored. Part (208) and (220) are various configured CNS remote viewer which are connected through hospital medical grade networks and also connected to the hub (212). Part (210) is Hospital information system and part (222) is PACS which is also connected to (214).

Part (226) is mobile telephone which is available over the counter or custom designed and is the mobile client. Part (224) is various CNS clients located remotely and having access to the entire system described above through internet network (228).
There are various unlimited users that are created for the system access. Three levels of authorizations are given to the users as listed below.
1. Normal- all users from the group and global users shall be able to select.
2. Restricted - Only the selected user and global users shall be able to select.
3. Confidential - Only the selected user and admin shall be able to select.
The user login is as follows.
Users is able to connect V2 server (216 ) from the local network or from web.
Unlimited concurrent users are able to login to the server.
Limit the number of users during installation based on the license. (By default 10 and upgraded.)
Users are prompted for username and password when he connects to V2 server.
User is listed with the Hospital, ICU and beds that are available for that user in a tree as shown below in Table 1. Table 1:

HOSPITAL 1 ICU1 BED1

BED 2

ICU 2 BED1

BED 2
HOSPITAL 2 ICU1 BED1

BED 2
Users are able to access any ICU / bed from the list. Concurrent users is able to access the same bed.

Selecting the CNS (106) displays the multi bed format (8 bed at a time and select the next 8 bed in 16 bed CNS) of the selected CNS with 1 w/f and its digital value (ECG and HR) of each bed
(178) and (124).
The individual bed selection is as follows.
Selecting the bed displays 3 waveforms, which are selected for full disclosure at CNS as shown
below.
All digital parameter available at CNS is displayed.
User are able to select Unlimited* Graphical and Tabular trend with maximum lmin resolution (By default limited to 1 Month)
User are able to select Alarm recall with filter for arrhythmia.
Alarm review for 30 sec is provided.
Waveform review is provided for 72 hrs. From the available list, user is able to select 1 min
waveform for displaying.
The 12 lead ECG review (138) and (148) is as follows.
All available records is listed and selected. Selected report is displayed in PDF viewer.
The major blocks of CNS server-Client with data base server are as shown in Figure 3 part (300).
The system along with database server ( part 216 ) will feature
■ Remote viewing of trend and waveform review via Virtual Private Network using Skyline 55 client software framework.
■ Centralized data storage management
■ Scalable monitoring capability 1-n beds.
■ Trend Data with full disclosure viewing over LAN or a WAN using the client software framework. When WAN is used, VPN can be configured

The major blocks of the system with database server are as disclosed in Figure 3 are:
Acquisition server (322) ,Remote Data Center agent (318) , DC-Acquisition agent (312) ,DB Server (310),DC Configuration (308),Storage (306),Web Server portal (304),Log-In Management 302). The functions of each of the blocks are explained as follows:
Acquisition Server (322): The server does the function of acquiring the waveform and numerical data from the patient monitors. The raw data acquired is sent to the local viewer (326) and local database (320) for presentation and storage. The raw data obtained is converted to presentable form and is sent to Local viewer (326). The local viewer displays the data in the different views like the multibed format, multipara, trend, recall as explained in Fig 1 part (120) and (122). The local viewer handles the different configurations and settings that is accessed by the user. The settings like user selectable waveforms and digital parameters, regional settings, CNS settings is solely handled by the viewer.
The acquisition server (322) sends the raw data to the local database (320). The local database handles the raw waveform, sorts and stores in different formats for various trends (156) and recall window (154), (152), (136).
The data is sorted and prepared for graphical, tabular trend (140), alarm recall (136), arrhythmia recall (134) and 12-Lead ECG recall (138), (148). The converted data is directly sent to the local viewer (326) for display. The acquisition server (322), local viewer (326) and the local database (320) together form the system described in the present invention.
Remote data center Agent (318): Remote data center agents are located in every CNS system. They act as agents that packetize the data (waveforms and numerical data) from each CNS and prepare the data as per a defined protocol. The agents are solely responsible for the data transfer from the CNS to the Data center acquisition agent (312). The data center agent acts individually and does not interfere with the CNS operation. The data is fetched from the local database and sent to the DC - Acquisition agent (312). Remote DC client agent (318) is to run as separate process and require no direct connection to the acquisition server (322). Frequency and resolution of the data acquisition is to determine the bandwidth of the data network.
Data center Acquisition Agent (312): Data center - Acquisition agent acts as a receiver. The agent will be present physically in the database server PC. The Data center- acquisition agent

will receive the data from all the remote data center - agents of all the Central Nursing Station systems as per the defined protocol and transfers the same to the database server. The Data center- acquisition agent is responsible for the data traffic management between the database server PC and the CNS systems.
The database server Part (310): The database server block handles the data received from the DC - acquisition agent and prepares the data for storage in a structured manner in the storage block. Data security and data management are the prime functions of the database server. Also the database server interacts with the Data center configuration in data preparation for the various types of clients like Mobile clients, Skyline55 remote clients in the Intranet and Internet Clients. There are only two types of viewer implementations they are Skyline real-time Viewer, and Skyline web viewer. Skyline real-time viewers runs only on the Skyline acquisition system, but the web viewer can run on any system that internet explorer (including mobile).
Data center- Configuration (308): The data center configuration block does the function of data preparation for the various types of clients who are logged on. The data center configuration block also handles the configuration of the clients and stores the settings of the clients. Data and web configuration and administration management functions, that includes registering/un-registering acquisition servers, client state data, logs, data backup/restore.
Storage (306): The storage block is responsible for proper storage of the CNS data. The storage of the data happens in a more structured manner.
Web Server Portal (304) and Log -in Management (302): The Web Server portal block handles the presentation of the data to all the clients. The primary function of the web server is to provide the required CNS data (patient data from a specified CNS) to the user. The Web server portal is deployed with proper internet security. The CNS data is made available to the hospital management if they have to link the same with their home website.
Log -in management is imperative to avoid multiple user log -ins. Only 10 concurrent log -ins should be made possible inclusive of mobile, intranet and internet users. A message is displayed through the client software prompting the user to log -on after some time, if the number of log -ins is 10. Also authenticated user -id and password is provided to the users to ensure secure
access.

Client Viewer: Skyline real-time viewer client.
Functionally it is the same as client software framework and it can run only on the acquisition system. Part 330 connected to the public network symbolically represented as 328, is an example for this client viewer. Part 332 is example for mobile client having wireless tablet PC or mobile telephone which can receive text SMS or multimedia SMS.
Skyline web viewer client (224) of fig 2: Web viewer can only display the stored waveform and parameter trend data of a bed/patient. It is accessed from any system that has Internet Explore application (228) ,Fig 2, including the mobile devices. There is no separate VPN configuration required, server system requires a fixed IP configuration depending the network, in LAN it is a
local IP, in WAN it will be public IP.
HL7 : Since the acquisition system is not connected directly with HIS, data server needs to handle the HL7 data and communicate the same with the respective acquisition sever, but the required data broadcasting can be done directly by the data server to the HIS (Hospital Information System) Part (210) Fig 2.
The detailed flow of 12 lead electro-cardiograph signal or any other vital sign from ECG machine part (112) to the CPU (106) is shown in Fig 4, Flowchart (400).
The step (400) is a start of application. The step (404) asks user to select display in multi-bed
view of the central nursing station.
The step (406) is selecting 12 lead ECG acquisition. In steps (408) and (410) the user is
prompted to select display in multi-para mode.
The step (416) will prompt user to select lead configuration, gain, filter and thermal paper motor
speed.
The step (418) will enable or disable the Pacer pulses generated from pacer implanted patient
which are sharp rectangular pulses also QRS beep sounds.
The step (420) will prompt caregiver to select Auto command either from ECG machine or from
display (102) or (104) and the signal monitoring will start.
At step (424) the ECG machine will generate a report and prompt the CPU (106) that it is ready.
The ECG machine (112) will generate report using thermal printer when caregiver selects the
'print' key on board (112) or from display (102) / (104).

The step (426) is a user selection for linking the records of ECG report with other vital signs generated by Bed side PMS connected to the same patient to whom ECG machine (112) is connected. When the caregiver desires to do so the system in return prompts the caregiver to enter the unique" Bed Identification number", Date time and the stored waveform and data . Upon receiving the consent from caregiver as in step (430) the information is sent to Part (106) and is awaited for further processing.
The detailed action taking place during ECG waveform review and diagnostic can be understood by Fig 5 flow chart (500).
The step (502) is starting of ECG information review. In step (504) the caregiver is prompted to select the display (102) or (104) in multi-bed view. The step (506) is to select 12 lead ECG acquisition. In step (508) the caregiver is prompted to select display in multi-para mode. The linked records as per Fig 4 step (426) and (428) which is stored in central server are displayed and the user is prompted to display one among them. The system will prompt the user about printing the data. Clicking Yes will print the ECG data.
Scalability:
In terms of server( part 216 ) scalability, there are two aspects considered they are: how many
concurrent clients can a single server maintain, and how does the protocol scale out. The same
hardware can support more concurrent clients with the. net. tcp protocol than HTTP polling
duplex. At the same time, however, scale-out of the net.tcp protocol requires backend affinity for
the duration of the TCP connection, while scale out of the HTTP polling duplex protocol can be
accomplished without similar guarantee at the HTTP layer, ...
Last aspect of performance to consider is network bandwidth. The size of a single HTTP request/response per message of the HTTP polling duplex protocol is clearly a losing proposition to the .NET Framing Protocol used for streaming multiple messages over TCP in the net.tcp
protocol.
One of the important feature is ability of the part (100) in Fig. 200, is to transfer up to 16 bed real-time waveform from Parts (202) in Fig. 2 and digital parameter data periodically to the requested client viewer Part (208) ,(220 )and (224) via information server using intranet or

internet part (228) through www. Likewise n-number of CNS can be connected to an information server and n-number of clients can be serviced in real-time. The scenario is quite similar to a live (real-time) video or audio web-cast over internet, but with predicated reliability. For the realtime streaming requirements ".net.tcp polling duplex technology" is used.
Net.tcp protocol is using multiple worker threads to receive and dispatch messages from the server. The HTTP polling duplex protocol builds on top of the HTTP stack where in Silverlight 4 software uses a single user interface thread to receive messages (even if the request has originated on a worker thread).
The advantages:
• Increase in throughput (decrease in latency) of data notifications a client application can receive from the server,
• Increase in the maximum number of connected client the server can support concurrently,
• Bandwidth reduction.

WE CLAIM:
1. A central nursing station/ system to determine the various physiological paramaters / vital
signs of patients, said system comprising:
plurality of patient monitor means, said each patient monior display comprises monitor
network means;
plurality of display means operatively connected with said patient monitor display means
to display scalable various physiological parameters of various patients ;
plurality of data network means opreatively connected with said pludisplay means ;
a central server means operatively connected with said data network means adpated to
store the data/information of said plurality of patient monitor means;
pluarlity of hospital information system and PACS operaively connected with said central
server means via a hub means to provide information/data to said server means; and
plurality of client means located remotely and connected with said storage means via the
internet.
2. System as clamied in claim 1 wherein said central server means comprises
an acquisition server adpated to acquire the waveform and numerical data from said
patient monitors and the raw data acquired is sent to the dual display means for
display/presentation;
a local database means connetced with said acquisition server to store the acquired
waveform and numerical data from said patient monitors and the raw data ; and
a remote data center means/ sender means operatively connected with said local database
and said acquisition server .
3. System as claimed in claim 1 wherein said local database handles the raw waveform,
sorts and stores in different formats for various trends and recall window and the data is
sorted and prepared for graphical, tabular trend , alarm recall, arrhythmia recall and 12-
Lead ECG recall and the converted data is directly sent to said display means for display.

4. System as clamied in claim 1 wherein said plurality display means comprises a pair of display means, said each display means adapted to display pluralit of patient bed details displaying physiologial parameters.
5. System as claimed in claim 1 wherein said remote data center agent means/ sender means operatively connected with a data center means adapted to packetize the data from each cenral nursing station system .
6. System as claimed in claim 5 wherein said data center means cormpsies :
a remote receiver means/ data center acquisition agent operatively connected with plurality of cenral nursing station adapted to receive data from plurality of remote data center agent /sender means all the remote data center adpated for the data traffic management between the database server PC and the CNS systems;
a data base server means operatively connected with said remote receiver means/ data center acquisition agent ;
a data center configuration operatively connected with said data base server means adapted for data preparation for the various types of clients who are logged on and also handles the configuration of the clients and stores the settings of the clients, Data and web configuration and administration management functions, that includes registering/un-registering acquisition servers, client state data, logs, data backup/restore.
a storage means operatively connected with said data center confguration adapted for proper storage of the CNS data and the storage of the data happens in a more structured manner; and
a server portal and log in means operatively connected with said storage means.

7. A method to determine, analyze, acquire and get protected review of the various
physiological parameters/data of various patients , said method comprising steps of:
selecting display in multi-bed view of a central nursing station/system;
selecting a 12 lead ECG acquisition/patient monitor;
selecting display in multi-para mode;
selecting lead configuration, gain, filter and thermal paper motor speed;
enabling or disabling the Pacer pulses generated from pacer implanted patient which are sharp rectangular pulses also QRS beep sounds;
selecting Auto command either from ECG machine or from display (102) or (104) and
the signal monitoring starts;
generating a report from the ECG machine and prompt the CPU (106) that it is ready;
generating report using thermal printer by the ECG machine (112) when caregiver selects the 'print' key on board (112) or from display (102) / (104);
linking the records of ECG report with other vital signs generated by Bed side PMS connected to the same patient to whom ECG machine (112) is connected.;
entering the unique" Bed Identification number", Date time and the stored waveform and
data;
upon receiving the consent from caregiver the information is sent to Part (106) and is
awaited for further processing.
8. A central nursing station/ system to determine the various physiological paramaters / vital
signs of patients as herein substantially described and illustrated with the accompanying
drawings.

9. A method to determine, analyze, acquire and get protected review of the various physiological parameters/data of various patients as herein substantially described and illustrated with the accompanying drawings.