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ADS1298: Augmented Leads in digital domain

Part Number: ADS1298

The ADS1298 data sheet says

9.3.1.7.3.1 Augmented Leads
In a typical implementation of the 12-lead ECG with eight channels, the augmented leads are calculated digitally.
In certain applications, it may be required that all leads are derived in analog rather than digital. The ADS1298
and ADS1298R provide the option to generate the augmented leads by routing appropriate averages to channels
5, 6, and 7.

I have highlighted

"In certain applications, it may be required that all leads are derived in analog rather than digital"

 

What applications would required leads to be derived in analog domain using hardware vs digital domain which can be done with firmware on a MCU?

Is it mandatory according to standard (60601 and its derivatives) that all leads of ECG be derived in analog domain?