Patent Publication Number: US-2021177292-A1

Title: Health and Vital Signs Monitoring Patch with Display and Making of Same

Description:
CROSS REFERENCE TO RELATED APPLICATION 
     This application is a continuation-in-part of U.S. patent application Ser. No. 16/711,744, filed on Dec. 12, 2019, the entire content of which is incorporated by reference herein. 
    
    
     TECHNICAL FIELD 
     This disclosure relates to electronics and in particular, a patch for monitoring and displaying health signs, vital signs, and the like. 
     BACKGROUND 
     Vital signs monitoring devices are capable of measuring multiple physiologic parameters of a patient. These physiologic parameters may include heart rate, electrocardiogram (ECG) signals, photoplethysmography (PPG) signals, and other like signals and information. The vital sign monitoring devices come in a variety of forms including smart watches, wearable devices, and the like. The use of such devices has become ubiquitous as users become more health conscious. The devices may be used in a variety of settings including medical facilities, home, and work, and while walking, exercising and performing other activities. The devices, however, lack depicting the multi-parametric measurements associated with the multiple sensing modalities on the devices such as ECG, oxygen saturation, temperature and pH, for example. In addition, the devices may be costly, need maintenance, and may be difficult to use or interpret. Consequently, there is a need for an easy to use vital signs monitoring device which may be more suitable and adaptable for a variety of environments. 
     SUMMARY 
     Disclosed herein are implementations of health and/or vital signs monitoring patch with integrated display and methods for making the patches or devices. 
     In implementations, a vital signs monitoring patch with integrated display includes a user access layer configured to have at least access to a display section and a first printed silver-silver chloride electrode, a polyethylene foam layer including at least a cut-out for a power supply, where the polyethylene foam layer is arranged to bond to the user access layer, a printed circuit board assembly (PCBA) layer including at least one vital sign monitoring sensor and the power supply, the PCBA layer is connected to the first printed silver-silver chloride electrode and a second printed silver-silver chloride electrode, where the PCBA layer is arranged to bond to the polyethylene foam layer, a sensor layer including reflection mode oximetry measurement components and the second printed silver-silver chloride electrode, a hydrogel based conductive adhesive configured to contact a user surface area, where the hydrogel based conductive adhesive is configured to interact between the user surface area and the second printed silver-silver chloride electrode, a medical tape layer, where the medical tape layer is configured to bond to the user surface area and the sensor layer, and a plunger arranged to operate within a cut-out on the polyethylene foam layer and connected to the PCBA layer, where the plunger is accessible on the user access layer and configured to power on the vital signs monitoring patch with integrated display via the power supply, and where access of the first printed silver-silver chloride electrode by a user completes a circuit with the second printed silver-silver chloride electrode. 
     In implementations, a vital signs monitoring patch with integrated display includes a top layer including at least access to a display, a top printed silver-silver chloride electrode and an activation device, a foam layer including at least a cut-out for a power supply and the activation device, where the polyethylene foam layer is arranged to bond to the top layer, a printed circuit board assembly (PCBA) layer having a top surface and a bottom surface, where the top surface including at least an electrocardiogram (ECG) sensor and the power supply, the ECG sensor connected to the first printed silver-silver chloride electrode and a second printed silver-silver chloride electrode, the bottom surface including at least an oximetry sensor and the second printed silver-silver chloride electrode, and the activation device connected to the PCBA layer, a hydrogel based conductive adhesive configured to contact a user skin surface, where the hydrogel based conductive adhesive is configured to interact between a user skin area and the second printed silver-silver chloride electrode, and a contact layer, wherein the contact layer is configured to bond to a user surface area and the bottom surface of the PCBA layer, and where the activation device is configured to power on the vital signs monitoring patch with integrated display via the power supply, and where access of the first printed silver-silver chloride electrode by a user completes a circuit with the second printed silver-silver chloride electrode. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The disclosure is best understood from the following detailed description when read in conjunction with the accompanying drawings and are incorporated into and thus constitute a part of this specification. It is emphasized that, according to common practice, the various features of the drawings are not to-scale. On the contrary, the dimensions of the various features are arbitrarily expanded or reduced for clarity. 
         FIG. 1  is a diagram of the multiple layers in a vital signs monitoring patch with display in accordance with certain implementations. 
         FIGS. 2A-E  are diagrams of reflection mode oximetry measurement components in accordance with certain implementations. 
         FIG. 3  is a diagram of reflection mode oximetry measurement components in accordance with certain implementations. 
         FIG. 4  is a perspective view of a vital signs monitoring patch with display in accordance with certain implementations. 
         FIG. 5  is a top view of the vital signs monitoring patch with display of  FIG. 4  in accordance with certain implementations. 
         FIG. 6  is a side view of the vital signs monitoring patch with display of  FIG. 4  in accordance with certain implementations. 
         FIG. 7  is a diagram of the multiple layers of the vital signs monitoring patch with display of  FIG. 4  in accordance with certain implementations. 
         FIG. 8  is a bottom view of a printed circuit board layer of the vital signs monitoring patch with display of  FIG. 4  in accordance with certain implementations. 
         FIG. 8A  is a diagram of the reflection mode oximetry measurement components of  FIG. 8  in accordance with certain implementations. 
         FIG. 8B  is a block diagram of a readout circuit for the reflection mode oximetry measurement system of  FIG. 8  in accordance with certain implementations. 
         FIG. 9  is an example diagram of a hardware architecture of a vital signs monitoring patch with display in accordance with certain implementations. 
         FIG. 10  is an example diagram of a software architecture of a vital signs monitoring patch with display in accordance with certain implementations. 
         FIGS. 11A-B  are an example diagram of an interface screen on a device for interacting with a vital signs monitoring patch with display in accordance with certain implementations. 
         FIGS. 12A-B  are an example diagram of an interface screen on a device for interacting with a vital signs monitoring patch with display in accordance with certain implementations. 
         FIG. 13  is a flowchart for reflection mode oximetry measurement for a vital signs monitoring patch with display in accordance with certain implementations. 
         FIG. 14  is a diagram of an example display architecture for a vital signs monitoring patch with display in accordance with certain implementations. 
         FIG. 15  is a diagram of an example display architecture for a vital signs monitoring patch with display in accordance with certain implementations. 
         FIGS. 16A and 16  B are diagrams of an example display architecture for a vital signs monitoring patch with display in accordance with certain implementations. 
     
    
    
     DETAILED DESCRIPTION 
     The figures and descriptions provided herein may be simplified to illustrate aspects of the described embodiments that are relevant for a clear understanding of the herein disclosed processes, machines, manufactures, and/or compositions of matter, while eliminating for the purpose of clarity other aspects that may be found in typical similar devices, systems, compositions and methods. Those of ordinary skill may thus recognize that other elements and/or steps may be desirable or necessary to implement the devices, systems, compositions and methods described herein. However, because such elements and steps are well known in the art, and because they do not facilitate a better understanding of the disclosed embodiments, a discussion of such elements and steps may not be provided herein. However, the present disclosure is deemed to inherently include all such elements, variations, and modifications to the described aspects that would be known to those of ordinary skill in the pertinent art in light of the discussion herein. 
     Embodiments are provided throughout so that this disclosure is sufficiently thorough and fully conveys the scope of the disclosed embodiments to those who are skilled in the art. Numerous specific details are set forth, such as examples of specific aspects, devices, and methods, to provide a thorough understanding of embodiments of the present disclosure. Nevertheless, it will be apparent to those skilled in the art that certain specific disclosed details need not be employed, and that embodiments may be embodied in different forms. As such, the exemplary embodiments set forth should not be construed to limit the scope of the disclosure. 
     The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting. For example, as used herein, the singular forms “a”, “an” and “the” may be intended to include the plural forms as well, unless the context clearly indicates otherwise. The terms “comprises,” “comprising,” “including,” and “having,” are inclusive and therefore specify the presence of stated features, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and/or groups thereof. 
     The steps, processes, and operations described herein are thus not to be construed as necessarily requiring their respective performance in the particular order discussed or illustrated, unless specifically identified as a preferred or required order of performance. It is also to be understood that additional or alternative steps may be employed, in place of or in conjunction with the disclosed aspects. 
     Yet further, although the terms first, second, third, etc. may be used herein to describe various elements, steps or aspects, these elements, steps or aspects should not be limited by these terms. These terms may be only used to distinguish one element or aspect from another. Thus, terms such as “first,” “second,” and other numerical terms when used herein do not imply a sequence or order unless clearly indicated by the context. Thus, a first element, step, component, region, layer or section discussed below could be termed a second element, step, component, region, layer or section without departing from the teachings of the disclosure. 
     As used herein, the terminology “determine” and “identify,” or any variations thereof includes selecting, ascertaining, computing, looking up, receiving, determining, establishing, obtaining, or otherwise identifying or determining in any manner whatsoever using one or more of the devices and methods are shown and described herein. 
     As used herein, the terminology “example,” “the embodiment,” “implementation,” “aspect,” “feature,” or “element” indicates serving as an example, instance, or illustration. Unless expressly indicated, any example, embodiment, implementation, aspect, feature, or element is independent of each other example, embodiment, implementation, aspect, feature, or element and may be used in combination with any other example, embodiment, implementation, aspect, feature, or element. 
     As used herein, the terminology “or” is intended to mean an inclusive “or” rather than an exclusive “or.” That is unless specified otherwise, or clear from context, “X includes A or B” is intended to indicate any of the natural inclusive permutations. That is if X includes A; X includes B; or X includes both A and B, then “X includes A or B” is satisfied under any of the foregoing instances. In addition, the articles “a” and “an” as used in this application and the appended claims should generally be construed to mean “one or more” unless specified otherwise or clear from the context to be directed to a singular form. 
     As used herein, the terminology “computer” or “computing device” includes any unit, or combination of units, capable of performing any method, or any portion or portions thereof, disclosed herein. For example, the “computer” or “computing device” may include at least one or more processor(s). 
     As used herein, the terminology “processor” indicates one or more processors, such as one or more special purpose processors, one or more digital signal processors, one or more microprocessors, one or more controllers, one or more microcontrollers, one or more application processors, one or more central processing units (CPU)s, one or more graphics processing units (GPU)s, one or more digital signal processors (DSP)s, one or more application specific integrated circuits (ASIC)s, one or more application specific standard products, one or more field programmable gate arrays, any other type or combination of integrated circuits, one or more state machines, or any combination thereof. 
     As used herein, the terminology “memory” indicates any computer-usable or computer-readable medium or device that can tangibly contain, store, communicate, or transport any signal or information that may be used by or in connection with any processor. For example, a memory may be one or more read-only memories (ROM), one or more random access memories (RAM), one or more registers, low power double data rate (LPDDR) memories, one or more cache memories, one or more semiconductor memory devices, one or more magnetic media, one or more optical media, one or more magneto-optical media, or any combination thereof. 
     As used herein, the terminology “instructions” may include directions or expressions for performing any method, or any portion or portions thereof, disclosed herein, and may be realized in hardware, software, or any combination thereof. For example, instructions may be implemented as information, such as a computer program, stored in memory that may be executed by a processor to perform any of the respective methods, algorithms, aspects, or combinations thereof, as described herein. Instructions, or a portion thereof, may be implemented as a special purpose processor, or circuitry, that may include specialized hardware for carrying out any of the methods, algorithms, aspects, or combinations thereof, as described herein. In some implementations, portions of the instructions may be distributed across multiple processors on a single device, on multiple devices, which may communicate directly or across a network such as a local area network, a wide area network, the Internet, or a combination thereof. 
     As used herein, the term “application” refers generally to a unit of executable software that implements or performs one or more functions, tasks or activities. For example, applications may perform one or more functions including, but not limited to, vital signs monitoring, health monitoring, telephony, web browsers, e-commerce transactions, media players, travel scheduling and management, smart home management, entertainment, and the like. The unit of executable software generally runs in a predetermined environment and/or a processor. 
     The non-limiting embodiments described herein are with respect to patches or devices and methods for making the patches or devices, where the patches or devices are vital signs monitoring or health signs monitoring patches or devices with integrated display. The patch or device and method for making the patch or device with integrated display may be modified for a variety of applications and uses while remaining within the spirit and scope of the claims. The embodiments and variations described herein, and/or shown in the drawings, are presented by way of example only and are not limiting as to the scope and spirit. The descriptions herein may be applicable to all embodiments of the device and the methods for making the devices. 
     Disclosed herein are implementations of health or vital (collectively “vital”) signs monitoring patches or devices with integrated display (collectively “patches”) and methods for making the patches. The vital signs monitoring patch with display is an external on-body, skin-contact patch. The patch is easily attached and removed from the user. The patch may use a combination of sensors, printed electronics, adhesives, batteries, display electronics, flexible materials or enclosures. In an implementation, the vital signs monitoring patch with display includes flexible display layers based on organic, electrochromic, or quantum dot display techniques and materials. The parameters that may be displayed on the patch include, but are not limited to, heart rate (HR), heart rate variability (HRV), oxygen saturation (SpO 2 ), body surface temperature, pH levels and the like 
     The vital signs monitoring patch with display integrates multiple sensing modalities such as, but not limited to, single or multi-lead electrocardiogram (ECG), photoplethysmography (PPG), oxygen saturation mapping (oximetry), temperature monitoring and pH monitoring in one wearable and disposable device for detecting pulsatile signals or the lack thereof. The device and captured data is used to monitor injuries over time such as open and/or closed wounds, trauma, pressure sores, post-surgical skin grafts, hydration, thermoregulation, hyperhidrosis, infection, muscle fatigue, dialysis, firefighting, stress, ischemic tissue status, and the like, by tracking the data from the multiple sensing modalities over time and the patch coverage area. 
     In an implementation, the vital signs monitoring patch with display is disposable. The disposability aspect means that internal electronics and power supply are sealed from external exposure. This disposability aspect of the patch permits sealing of the structure to provide a dust tight patch. In addition, the patch provides protection against temporary immersion in water. In an implementation, the patch may have an International Electrotechnical Commission (IEC) protection rating of IPX 67. Due its disposability, the patch may have a small form factor including both size and weight. This makes it easy for the user to wear without much discomfort. 
     In an implementation, the variety of sensors may include, but is not limited to, a single lead ECG sensor, a PPG sensor, temperature sensors, and an accelerometer. In an implementation, the PPG sensor is a reflection mode oximetry measurement sensor. In an implementation, the reflection mode oximetry measurement sensor may include light emitting diodes (LEDs) and photodiodes. The LEDs may be red LEDs, near infrared (NIR) LEDs, and/or green LEDs. 
     In an implementation, the patch may include a low power microcontroller with Bluetooth® for communication, an analog front-end (AFE) for measuring ECG and oximetry signals (PPG) and oxygen saturation (SpO 2 )), screen printed Silver-Silver Chloride electrodes (Ag—AgCl), an accelerometer, temperature sensor, pH sensor, and an oximetry layer including the LEDs and photodiodes on the same layer (or plane). 
     Power for the patch is internally supplied by a flexible battery as described herein. The flexible battery may permit the patch to be run in a continuous mode of operation for a defined time period. For example, the defined time period may be 7 days. The data from the patch may be communicated to a mobile device for display or analysis. In an implementation, the communication may be done via wireless, Bluetooth®, and the like. The data may include ECG live data, heart rate, heart rate variability, fall detection, SpO 2 , pH, body surface temperature, and the like. In an implementation, the flexible battery is sealed. In an implementation, the flexible battery is rechargeable. 
       FIG. 1  is a diagram of the multiple layers in a vital signs monitoring patch with display  1000  in accordance with certain implementations. 
     Layer 1 of the vital signs monitoring patch with display  1000  is a user access layer  1100  which includes a display section  1125  and a top ECG electrode  1150 . The display section  1100  is a printed light emitting device which displays heart rate information from ECG electrodes, SpO 2  levels, body surface temperature, and the like. In an implementation, the display section  1100  is a 3-digit 7-segment display. In an implementation, the display section  1100  may include multiple display sections for displaying different physiological parameters as described herein. In an implementation, the display section  1100  is implemented using organic, electrochromic, or quantum dot display techniques and materials as described herein. In an implementation, the display section  1100  is flexible. The top ECG electrode  1150  is a screen-printed Ag—AgCl ECG electrode which is touchable or engageable by a user to complete an ECG sensor circuit. 
     Layer 2 is a polyethylene foam layer  1200  which may adhere to the user access layer  1100 . The polyethylene foam layer  1200  may have a laser cut-out  1210  for encompassing and protecting a power supply unit  1300  and an assembled printed circuit board (PCBA) layer  1400 , and a cut-out  1220  for an on/off plunger. 
     Layer 3 is a power supply unit  1300 . In an implementation, the power supply unit  1300  may be a stack of Lithium polymer or similar batteries providing 3.3 V and 140 mAh, for example. In an implementation, the power supply unit  1300  may be a flexible battery. The power supply unit  1300  provides power to the various components on the vital signs monitoring patch with display  1000 . 
     Layer 4 is the PCBA layer  1400  which may include active and passive components as described herein and adhere to layer 2. In an implementation, the PCBA layer  1400  may include, but is not limited to, an accelerometer, pH sensor, and temperature sensor(s). In an implementation, the accelerometer may be used for activity tracking such as steps, sleep efficiency, and sleep staging. In an implementation, one or more temperature sensors may be used to determine a temperature profile for a wound, for example. The one or more temperature sensors may sense or monitor surface temperatures of a localized body area. In an implementation, the pH sensor may monitor the pH levels of a localized body area. The pH level may vary from 0 to 14 and as stated herein, may be displayed via layer 1. For example, pH of normal healing wounds ranges from 5.5 to 6.5 and pH of nonhealing wounds is greater than 6.5. In an implementation, the pH sensors may be potentiometric pH sensors. In an implementation, the pH sensors may be implemented using carbon/polyaniline and Ag—AgCl electrodes. 
     A bottom side of a layer 5 is shown in  FIG. 1 . Layer 5 is a sensor layer  1500  which may adhere to the PCBA layer  1400 . The sensor layer  1500  may include reflection mode oximetry measurement components  1525  and a bottom ECG electrode  1550 . In an implementation, the bottom ECG electrode  1550  may be a screen-printed Ag—AgCl ECG electrode which interfaces with a user skin via a hydrogel layer. For example, the bottom ECG electrode  1550  may contact the skin area on the chest near the heart. Other skin surface areas may also be used. Operationally, a user may contact the top ECG electrode  1150 , for example using an index finger of the hand from the opposing side of the body (right hand if patch is placed near heart). Contact of the index finger with the top ECG electrode  1150  completes the circuit with the bottom ECG electrode  1550  for single lead (two electrode-based) ECG measurements. 
     In an implementation, the data may be streamed to a device application through a Bluetooth® connection.  FIGS. 11A-B  are an example diagram of an interface screen  11000  on a device for interacting with a vital signs monitoring patch with display in accordance with certain implementations. The interface screen  11000  may have a link or tab  11100  for selection of a sub-menu for EGG graphic display  11200 . The ECG graphic display  11200  may stream the live ECG signal showing distinct QRS complexes and reports the heart rate and heart rate variability derived from the R-R peak intervals. 
     Oximeters sense oxygen saturation in tissues by optically quantifying concentrations of oxyhemoglobin (HbO 2 ) and deoxyhemoglobin (Hb). Pulse oximetry is one modality for ratiometric optical measurements on pulsatile arterial blood by leveraging photoplethysmography (PPG) at a minimum of two distinct wavelengths. PPG comprises optoelectronic components such as LEDs and photodiodes. In an implementation, the reflection mode oximetry measurement components  1525  (also referred to as an oximetry layer) of layer 5 may include a 4×4 array  1530  of red LEDs (4)  1535 , NIR LEDs (4)  1545 , and photodiodes (8)  1540  for a total of 16 pixels to facilitate reflection mode oximetry measurements. In an implementation, the 4×4 array  1530  provides a flexible reflection oximetry platform for single point measurements of heart rate, heart rate variability, SpO 2  and 2D oxygenation mapping of localized tissues. 
     The molar absorption coefficients of HbO 2  and Hb are disparate at the red and NIR wavelengths. The red LEDs  1535  and the NIR LEDs  1545  act as emitters (converting electrical energy into light energy) where light is transmitted at 610 nm and 725 nm wavelengths, respectively. In an implementation and as shown in  FIG. 3 , red and green (530 nm) may also be used as LED combinations. 
     The photodiodes  1540  sense the non-absorbed light from the LEDs. The signals are inverted by means of an operational amplifier. These signals are interpreted as light that has been absorbed by the tissue being probed and are assigned to direct current (DC) and alternating current (AC) components. The DC component is treated as light absorbed by the tissue, venous blood, and non-pulsatile arterial blood. The AC component is treated as pulsatile arterial blood. 
     Data from the reflection mode oximetry measurement components  1525  of layer 5 may be streamed to a device application.  FIGS. 12A-B  are an example diagram of an interface screen  12000  on a device for interacting with a vital signs monitoring patch with display in accordance with certain implementations. The interface screen  12000  may have a link or tab  12100  for selection of a sub-menu for a Patch Oximetry display  12200 . At the Patch Oximetry display  12200 , a user may view a live stream of the PPG waveform with well-delineated anacrotic (rising) and dicrotic (notch) characteristics. In an implementation, the Patch Oximetry display  12200  may display 2D contour maps  12300  in real-time that provide the perfusion status of a localized region sampled by the oximetry layer, where the oximetry layer includes the LEDs and photodiodes. The 2D contour maps  12300  are enabled via the array  1530  as described with respect to  FIGS. 2A-E , and the PCBA layer  7600  of  FIG. 7 , for example. In an implementation, the Patch Oximetry display  12200  may display parameters reflecting PPG-specific heart rate, heart rate variability, and oxygen saturation. In an implementation, the Patch Oximetry display  12200  may display surface temperature, pH levels, and other biomarker or physiological parameters. 
     In an implementation, the size of the array may vary without departing from the scope of the specification or claims. In an implementation, the number of pixels may vary without departing from the scope of the specification or claims. In an implementation, the number of LEDs for specific wavelengths or frequencies may vary without departing from the scope of the specification or claims. In an implementation, different wavelengths or frequencies may be used without departing from the scope of the specification or claims. 
     Layer 6 is a spacer ribbon-like layer  1600  around layer 5. The spacer ribbon-like layer  1600  may bond to the skin of the user and may hold the entire patch in position on the skin. For example, the spacer ribbon-like layer  1600  may be a medical tape which consists of a porous, highly breathable, white elastic multilayer polyurethane/synthetic rubber based non-woven fabric. The non-woven fabric may be coated on one side with a pressure sensitive adhesive which bonds to a user skin surface and an adhesive on the other side for bonding with layer 5. 
     As referenced herein above, the vital signs monitoring patch with display may also include an application which may run on a device such as mobile devices, end user devices, cellular telephones, Internet Protocol (IP) devices, mobile computers, laptops, handheld computers, PDAs, personal media devices, smartphones, notebooks, notepads, phablets, smart watches, and the like (collectively “user device”). The vital signs monitoring patch with display may wirelessly communicate with the user device and the application together with the user device may analyze, display and provide alerts to a user the vitals signs data collected by the vital signs monitoring patch with display. The vital signs monitoring patch with display may interface with the application to measure, stream and record real-time data for providing comprehensive sensing information to user(s).  FIGS. 11A-B  and  FIGS. 12A-B  are example diagrams of interface screens for reviewing the sensor data as described herein. 
       FIGS. 2A-E  are diagrams of reflection mode oximetry measurement components  2000  in accordance with certain implementations. The reflection mode oximetry measurement components  2000  may include an array of red LEDs  2100 , NIR LEDs  2200 , and photodiodes  2300 , where a shaded area reflects a light emitting area. In an implementation, the reflection mode oximetry measurement components  2000  may include a red LED array layer  2005 , a NIR LED array layer  2010 , and a photodiode array layer  2015 . The red LED array layer  2005  may include the red LEDs  2100  in a defined pattern and a connector  2105 . The NIR LED array layer  2010  may include the NIR LEDs  2200  in a defined pattern and a connector  2205 . The photodiode array layer  2015  may include the photodiodes  2300  in a defined pattern and a connector  2305 . The reflection mode oximetry measurement components  2000  may include an interface board  2400  which connects to a PCBA such as PCBA layer  1400  of  FIG. 1 . The connectors  2105 ,  2205 , and  2305  each connect to connectors  2110 ,  2210 , and  2310 , respectively, on the interface board  2400  to carry or send signals to the appropriate components on the PCBA. 
     In an implementation, the red LEDs  2100  may emit approximately at 610 nm and the NIR LEDs  2200  may emit around 725 nm. In an implementation, the LED active areas for the red LEDs  2100  and the NIR LEDs  2200  may be approximately 7.0×7.0 mm 2 . In an implementation, the photodiode active area may be approximately 7.0×7.0 mm 2 . In an implementation, the spacing between the red LEDs  2100 , NIR LEDs  2200 , and photodiodes  2300  may be approximately 5.0 mm AC and DC signal magnitudes drop off exponentially with increased spacing between emitters and detectors (or photodiodes). The array configuration and spacing of the red LEDs  2100 , NIR LEDs  2200 , and photodiodes  2300  enable 2D contour mapping for the skin surface proximate to the patch contact area. This permits determination of blood flow, temperature, and other physiological parameters at different points relative to the patch contact area and therefore the physiological conditions at different points with respect to, for example, a wound. For example, analysis of the 2D contour maps may show healing at one part of the wound but not at another part of the wound. 
       FIG. 3  is a diagram of reflection mode oximetry measurement components  3000  in accordance with certain implementations. In an implementation, the reflection mode oximetry measurement components  3000  may include an array of red LEDs  3100 , green LEDs  3200 , and photodiodes  3300 . In an implementation, the red LEDs  3100  may emit approximately at 610 nm and the green LEDs  3200  may emit around 530 nm. In an implementation, the LED active areas for the red LEDs  3100  and the green LEDs  3200  may be approximately 10.0×10.0 mm 2 . In an implementation, the spacing between the red LEDs  3100 , NIR LEDs  3200 , and photodiodes  3300  may be approximately 5.0 mm. 
       FIG. 4  is a perspective view of a vital signs monitoring patch with display  4000  in accordance with certain implementations.  FIG. 5  is a top view of the vital signs monitoring patch with display of  FIG. 4  in accordance with certain implementations.  FIG. 6  is a side view of the vital signs monitoring patch with display of  FIG. 4  in accordance with certain implementations. The vital signs monitoring patch with display  4000  may include a power button  4100 , a display section  4200 , and a front or top ECG electrode  4300 . In an implementation, the vital signs monitoring patch with display  4000  may include a charging port  4400 . The power button  4100  is configured to power on or off the vital signs monitoring patch with display  4000 . The display section  4200  depicts information related to physiological parameters sensed or captured by the vital signs monitoring patch with display  4000  as described herein. The display section  4200  is implemented as described herein. The front or top ECG electrode  4300  is part of a two ECG electrode configuration, where a bottom of the vital signs monitoring patch with display  4000  includes a bottom ECG electrode  4350  as shown in  FIG. 6 , and functions or operates as described herein. The front or top ECG electrode  4300  is configured such that accidental or incidental touching of the front or top ECG electrode  4300  is minimized. In an implementation, the front or top ECG electrode  4300  is touchable at a plane below the plane of the display section  4200 . The charging port  4400  permits charging of the vital signs monitoring patch with display  4000 . In an implementation, the vital signs monitoring patch with display  4000  may include a wireless charger. 
       FIG. 7  is a diagram of the multiple layers of the vital signs monitoring patch with display  4000  in accordance with certain implementations. 
     Layer 1 is a top cover  7100  which includes a cut-out  7110  for contact access to a front or top ECG electrode  7620 , a cut-out  7120  for a display  7400 , and a power button indicator  7130  for a plunger or power button  7200 . In an implementation, the top cover  7100  may be sticker paper or acrylic material which includes an adhesive on the bottom surface of the top cover  7100 . 
     Layer 2 is the plunger or power button  7200  which is in contact with the top cover  7100  at the power button indicator  7130  and with the PCBA layer  7600  of layer 6 via a cut-out  7330  in layer 3. Pressing at the power button indicator  7130  engages the plunger or power button  7200 , which in turn switches a switch on the PCBA layer  7600 , for example, to power on the vital signs monitoring patch with display  4000 . 
     Layer 3 is a foam spacer  7300  which includes a cut-out  7310  for the front or top ECG electrode  7620 , a cut-out  7320  for the display  7400 , and a cut-out  7330  for the plunger or power button  7200 . In an implementation, the foam spacer  7300  is a double sided, adhesive coated urethane foam tape for bonding with the top cover  7000  and the PCBA layer  7600 . In an implementation, the foam spacer  7300  has a defined thickness to mitigate inadvertent ECG circuit completion, provide placement of the display  7400 , and provide placement of a battery  7500 . 
     Layer 4 is the display  7400 . In an implementation, the display  7400  is a 3-digit, 7-segment display which depicts at least the physiological parameters described herein. In an implementation, the display  7400  is implemented as described herein. The display  7400  is electrically and mechanically connected to the PCBA layer  7600 . 
     Layer 5 is the battery  7500 . In an implementation, the battery  7500  is a polymer Lithium battery or battery stack. In an implementation, the battery  7500  is rechargeable. The battery  7500  is connected to the PCBA layer  7600  and/or the display  7400 . 
     Layer 6 is the PCBA layer  7600 . The PCBA  7600  includes active and passive components section  7610 , the front or top ECG electrode  7620  on one side or a top surface of the PCBA layer  7600  and a bottom ECG electrode on another side or bottom surface of the PCBA layer  7600 . In implementations, the PCBA layer  7600  can be a polyimide, polyethylene terephthalate (PET), thermoplastic polyurethane (TPU), or like substrate. In implementations, passive components such as resistors, capacitors, and inductors included in the active and passive components section  7610  can be additively added by using a variety of processes such as inkjet, selective coating, screen printing, dispensing, transfer, lamination, curing, and/or subtractively tuned following traditional PCB manufacturing processes such as masking, etching, and the like, either as a sheet to sheet or as a roll to roll process. In implementations, the active and passive components section  7610 , the front or top ECG electrode  7620 , the bottom ECG electrode, the power button indicator  7130 , the plunger or power button  7200 , the display  7400 , and the battery  7500  can be electrically connected, as appropriate and applicable, to each other using traces which can be additively added by using a variety of processes such as inkjet, selective coating, screen printing, dispensing, transfer, lamination, curing, or subtractively added following traditional PCB manufacturing processes such as masking, etching, and the like either as a sheet to sheet or as a roll to roll process. 
     Layer 7 is a double-sided medical tape layer  7700  which includes a cut-out  7710  for the active and passive components section  7610  and a cut-out  7720  for the bottom ECG electrode. The double-sided medical tape layer  7700  has adhesive on both sides which bonds to the PCBA layer  7600  and the medical tape layer  7800   
     Layer 8 is the medical tape layer  7800  which includes a cut-out  7810  for the active and passive components section  7610  and a cut-out  7820  for the bottom ECG electrode. The medical tape layer  7800  includes a medical adhesive to bond to the user skin surface. 
     Layer 9 is a hydrogel conductive adhesive patch  7900  which is connected to the bottom ECG electrode  7630 . 
       FIG. 8  is a bottom view of the PCBA layer  7600  in accordance with certain implementations. A bottom surface  8000  of the PCBA layer  7600 , for example, includes a first temperature sensor  8100 , a second temperature sensor  8200 , a bottom ECG electrode  8300 , and reflection mode oximetry measurement components  8400 . In an implementation, the bottom ECG electrode  8300  may be a screen-printed Ag—AgCl electrode. In an implementation, the reflection mode oximetry measurement components  8400  may be configured and function and operate as shown in  FIGS. 2A-2E . In an implementation, the reflection mode oximetry measurement components  8400  may be configured and function and operate as described in the specification herein. In an implementation, the reflection mode oximetry measurement components  8400  may include red LEDs  8410 , NIR LEDs  8420 , and photodiodes  8430  which function and operate as described in the specification herein. The first temperature sensor  8100  and the second temperature sensor  8200  permit generation of a temperature profile for a wound, for example, to see whether healing is progressing. The parameters may be displayed on the display  7400  or transmitted to another device which may show, for example, a 2D thermal contour. In implementations, LEDs, photodiodes, and other components which are surface mount technology components or die can be attached using solder, conductive adhesive, anisotropic conductive film (ACF), wire bonding, thermosonic bonding that is deposited by printing, inkjet, selective coating, screen printing, dispensing, lamination, curing, and/or bonding. In implementations, the LEDs and photodiodes can be placed discretely or gang placed or transferred on a roll. In implementations, the LEDs and photodiodes can be top firing or bottom firing. In the case of bottom firing components, the components can be placed on the topside of the substrates with a cavity in the flex to expose the active area. In the case of top firing components, the components can be attached to the bottom side of the substrate. In implementations, the SMT components can be encapsulated for ruggedization. 
       FIG. 8A  is a diagram of the reflection mode oximetry measurement components  8400  in accordance with certain implementations. The reflection mode oximetry measurement components  8400  may be configured in an array  8405  which may include an array of red LEDs  8410  (shown as R 1 -R 4 ), array of NIR LEDs  8420  (shown as N 1 -N 4 ), and an array of photodiodes  8430  (shown as P 1 -P 8 ), where each array is configured in a defined pattern. Readout from the array  8405  may be implemented by sampling in a raster format. In an implementation, a raster pattern  8500  may be done from top to bottom. In an implementation, the array  8405  may be read out by sampling readout blocks  8600  from readout block  1  to readout block  9  (RB 1 -RB 9 ). As an illustrative example, RB 1  may include P 1 , R 1 , N 1  and P 2 , RB 2  may include R 1 , P 3 , P 2  and N 2 , RB 3  may include P 3 , R 2 , N 2  and P 4 , RB 4  may include N 1 , P 8 , P 2  and R 4 , RB 5  may include P 2 , R 4 , N 2  and P 6 , RB 6  may include N 2 , P 6 , P 4  and R 3 , RB 7  may include P 8 , N 4 , R 4  and P 7 , RB 8  may include R 4 , P 7 , P 6  and N 3 , and RB 9  may include P 6 , N 3 , R 3  and P 5 . In implementations, light guides can be additively added by using a variety of processes such as inkjet, selective coating, screen printing, dispensing, transfer, lamination, curing or subtractively added following traditional PCB manufacturing processes such as masking, etching, and the like, laser trimming either as a sheet to sheet or as a roll to roll process. 
       FIG. 8B  is a block diagram of a readout circuit  8600  for a reflection mode oximetry measurement system in accordance with certain implementations. The readout circuit  8600  includes a multiplexor  8700  which is connected to analog front-end (AFE)  8750  and a low power processor with Bluetooth  8800 . The AFE  8750  is connected to and receives inputs (IN 1 -IN 3 ) from photodiodes (PD)  8900  and controls transmission (TX 1 -TX 4 ) by red LEDs  8910  and NIR LEDs  8920 . In an implementation, the red LEDs  8910  and NIR LEDs  8920  are switched on/off by the multiplexer  8700  and a current source within the AFE  8750 . The current produced by the photodiodes  8900  are converted into voltages (transimpedance amplifier), time demultiplexed, and digitized back through the AFE  8750  and then transmitted to an application on a mobile device  8950 . The AFE  8750 , the red LEDs  8910 , the NIR LEDs  8920 , the photodiodes  8900 , and the low power processor with Bluetooth  8800  may function and operate as described in the specification herein. 
       FIG. 9  is an example diagram of a hardware architecture of a vital signs monitoring patch with display  9000  in accordance with certain implementations. The vital signs monitoring patch with display  9000  includes printed Ag—AgCl electrodes  9100 , negative and a positive electrodes, for taking ECG measurements. In an implementation, the printed Ag—AgCl electrodes  9100  are screen-printed on different sides of a PCB. The Ag—AgCl electrodes  9100  are connected to an analog front-end (AFE)  9200 , which further includes connections from an accelerometer  9300  and a PPG sensor  9400  (shown as oximetry SpO 2 ). The AFE  9200  is connected to a processor  9500 , which is further connected to a LED display  9600 , temperature sensor(s)  9700 , pH sensor  9800 , and antenna  9900 . In an implementation, the processor  9500  is a low power MCU with integrated Bluetooth®. In an implementation, the antenna  9900  is a Bluetooth® which may communicate with a device  9950  using a corresponding antenna  9975 . In an implementation, the hardware architecture may, in part, be implemented on the PCBA layer  7600 . 
       FIG. 10  is an example diagram of a software architecture of a vital signs monitoring patch with display  10000  in accordance with certain implementations. A processor software/firmware of the vital signs monitoring patch with display  10000  includes, but is not limited to, a power module  10100 , a data transfer module  10150 , and drivers  10200  for the LEDs  10210 , AFE  10220 , Bluetooth® stack  10230 , accelerometer  10240 , display  10250 , temperature sensor  10260 , oximetry  10270 , serial peripheral interface  10280 , ECG sensor, and the like. An application device  10500  may include, but is not limited to, applications to process and display PPG data  10510 , ECG data  10520 , heart rate variability data  10530 , temperature  10540 , step count/fall detection (via accelerometer)  10550 , blood pressure and like data. The application device further includes a data storage mode  10580 , a Bluetooth® stack  10585 , and other libraries  10590 . In an implementation, the software/firmware architecture may, in part, be implemented on or with the processor  9500 . 
       FIG. 13  is a flowchart for a method  13000  for reflection mode oximetry measurement for a vital signs monitoring patch with display in accordance with some implementations. The method  13000  includes: dividing  13100  an oximetry layer into a defined set of pixel areas; sampling  13200  each pixel area at a defined sampling rate; plotting  13300  data from the defined set of pixel areas; and generating  13400  2D spatial maps. The method  13000  may be implemented, in part, by the processor  9500 , display  9600 , and other applicable components. 
     The method  13000  includes dividing  13100  an oximetry layer into a defined set of pixel areas. Each pixel area of the defined set of pixel areas may include a pair of LEDs and a pair of photodiodes. In an implementation, the pair of LEDs includes a red LED and a NIR LED. In an implementation, the pair of LEDs includes a red LED and a green LED. 
     The method  13000  includes sampling  13200  each pixel area at a defined sampling rate. Each of the defined set of pixels areas are sampled at a defined sampling rate in a defined pattern. In an implementation, the defined pattern is a raster pattern. In an implementation, the defined sampling rate is 500 Hz. 
     The method  13000  includes plotting  13300  data from the defined set of pixel areas. The data from the defined set of pixels areas is plotted using one or more interpolation techniques. In an implementation, the one or more interpolation techniques is a nearest neighbor interpolation. 
     The method  13000  includes generating  13400  2D spatial maps. 2D contour maps are generated from the plotted data for different parameters. For example, a 2D contour map may be generated for the red LEDs, the NIR LEDs, the green LEDs, ΔSpO 2  and other like parameters. 
       FIG. 14  is a diagram of an example Organic Light Emitting Diode (OLED) stack  14000  for a vital signs monitoring patch with display in accordance with certain implementations. The OLED stack  14000  may include a seal layer  14100 , a cathode layer  14200 , an emissive layer  14300 , a conductive layer  14400 , an anode layer  14500 , and a substrate  14600 . In an implementation, the emissive layer  14300  may be a film of organic compound which emits light in response to current injection. The organic compound may be organic polymers, inks, light emitting polymers, and the like. In an implementation, the conductive layer  14400  may be organic polymers, inks, and the like. 
       FIG. 15  is a diagram of an example Electrochromic Device (ECD) stack  15000  for a vital signs monitoring patch with display in accordance with certain implementations. The ECD stack may include a substrate  15100 , an electrolyte layer  15200 , electrochromic layers  15300  and  15310 , electrodes  15400  and  15410 , and a substrate  15500 . In this instance, the electrochromic materials are organic or inorganic substances that change color when charged with electricity. The ECD controls optical properties, such as transmission, absorption, reflectance and/or emittance, in a continual but reversible manner by applying voltage. The ECDs may be printed on plastics, paper, and the like and provide flexible yet robust structures. The ECDs use ultra-low power and are activated by small currents. The ECDs can be integrated with sensors for motion, touch, proximity, temperature and the like. 
       FIGS. 16A and 16B  are architectures for quantum dot light emitting diodes (QLEDs).  FIG. 16A  is a diagram of a quantum dot  16000 , which are semiconductor particles with optical and electrical properties in the nanometer size area. The quantum dot  16000 , in general, includes a core  16100 , a shell  16200  and ligands  16300 . The core  16100  are the material emitting colors, the shell  16200  are coatings to protect the core  16100 , and the ligands  16300  are long chain molecules so that the quantum dots can be printed in a liquid form. 
       FIG. 16B  is a diagram of a QLED stack  16500  for a vital signs monitoring patch with display in accordance with certain implementations. The QLED stack  16500  includes a negative voltage electrode  16600 , a charge injection material layer  16650 , a core-shell quantum dot layer  16700 , a charge injection layer  16750 , a positive voltage electrode  16800 , and a transparent substrate  16850 . The QLEDs produce pure monochromatic light (red, green, blue) and have low power consumption. Charge injected in the QLED stack  16500  results in electroluminescence. The chemical make-up and size of the quantum dots allows tuning of the color of the emitted light. 
     In general, a vital signs monitoring patch with integrated display includes a user access layer configured to have at least access to a display section and a first printed silver-silver chloride electrode, a polyethylene foam layer including at least a cut-out for a power supply, where the polyethylene foam layer is arranged to bond to the user access layer, a printed circuit board assembly (PCBA) layer including at least one vital sign monitoring sensor and the power supply, the PCBA layer is connected to the first printed silver-silver chloride electrode and a second printed silver-silver chloride electrode, where the PCBA layer is arranged to bond to the polyethylene foam layer, a sensor layer including reflection mode oximetry measurement components and the second printed silver-silver chloride electrode, a hydrogel based conductive adhesive configured to contact a user surface area, where the hydrogel based conductive adhesive is configured to interact between the user surface area and the second printed silver-silver chloride electrode, a medical tape layer, where the medical tape layer is configured to bond to the user surface area and the sensor layer, and a plunger arranged to operate within a cut-out on the polyethylene foam layer and connected to the PCBA layer, where the plunger is accessible on the user access layer and configured to power on the vital signs monitoring patch with integrated display via the power supply, and where access of the first printed silver-silver chloride electrode by a user completes a circuit with the second printed silver-silver chloride electrode. 
     In an implementation, the sensor layer is integrated as a bottom surface of the PCBA layer. In an implementation, the first printed silver-silver chloride electrode is printed on a top surface of the PCBA layer. In an implementation, the polyethylene foam layer has a cut-out for first printed silver-silver chloride electrode and has a defined thickness to mitigate inadvertent circuit completion between the first printed silver-silver chloride electrode and the second printed silver-silver chloride electrode. In an implementation, the reflection mode oximetry measurement components further comprising an array of first wavelength light emitting diodes, an array of second wavelength light emitting diodes, and an array of photodiodes, where the array of first wavelength light emitting diodes, the array of second wavelength light emitting diodes, and the array of photodiodes are configured to enable contour mapping of a patch coverage area. In an implementation, the at least one vital signs monitoring sensor is an electrocardiogram (ECG) sensor. In an implementation, the PCBA layer further includes at least one temperature sensor. In an implementation, the PCBA layer further includes a pair of temperature sensors configured to provide a thermal profile of a patch coverage area. In an implementation, the PCBA layer further includes a pH sensor. In an implementation, the PCBA layer further includes an accelerometer which is configured to detect inclination and fall detection data. In an implementation, the PCBA further includes a wireless component which is configured to transmit at least vital signs data to a vital signs monitoring device. In an implementation, the medical tape layer, the polyethylene foam layer, and the user access layer are arranged and configured to provide bonding and sealing against environmental exposure. In an implementation, the user access layer includes the display section. 
     In general, a vital signs monitoring patch with integrated display includes a top layer including at least access to a display, a top printed silver-silver chloride electrode and an activation device, a foam layer including at least a cut-out for a power supply and the activation device, where the polyethylene foam layer is arranged to bond to the top layer, a printed circuit board assembly (PCBA) layer having a top surface and a bottom surface, where the top surface including at least an electrocardiogram (ECG) sensor and the power supply, the ECG sensor connected to the first printed silver-silver chloride electrode and a second printed silver-silver chloride electrode, the bottom surface including at least an oximetry sensor and the second printed silver-silver chloride electrode, and the activation device connected to the PCBA layer, a hydrogel based conductive adhesive configured to contact a user skin surface, where the hydrogel based conductive adhesive is configured to interact between a user skin area and the second printed silver-silver chloride electrode, and a contact layer, wherein the contact layer is configured to bond to a user surface area and the bottom surface of the PCBA layer, and where the activation device is configured to power on the vital signs monitoring patch with integrated display via the power supply, and where access of the first printed silver-silver chloride electrode by a user completes a circuit with the second printed silver-silver chloride electrode. 
     In an implementation, the foam layer has a defined thickness to mitigate inadvertent circuit completion between the first printed silver-silver chloride electrode and the second printed silver-silver chloride electrode. In an implementation, the oximetry sensor further includes an array of first wavelength light emitting diodes, an array of second wavelength light emitting diodes, and an array of photodiodes, where the array of first wavelength light emitting diodes, the array of second wavelength light emitting diodes, and the array of photodiodes are configured to enable contour mapping of a patch coverage area. In an implementation, the PCBA layer further includes at least one temperature sensor, a pH sensor, and an accelerometer. In an implementation, the at least one temperature sensor is a pair of temperature sensors configured to provide a thermal profile of a patch coverage area. In an implementation, the patch includes a rechargeable dock, the rechargeable dock configured to recharge the power supply. In an implementation, the display is a printed display. 
     The construction and arrangement of the methods as shown in the various exemplary embodiments are illustrative only. Although only a few embodiments have been described in detail in this disclosure, many modifications are possible (e.g., variations in sizes, dimensions, structures, shapes and proportions of the various elements, values of parameters, mounting arrangements, use of materials and components, colors, orientations, etc.). For example, the position of elements may be reversed or otherwise varied and the nature or number of discrete elements or positions may be altered or varied. Accordingly, all such modifications are intended to be included within the scope of the present disclosure. The order or sequence of any process or method steps may be varied or re-sequenced according to alternative embodiments. Other substitutions, modifications, changes, and omissions may be made in the design, operating conditions and arrangement of the exemplary embodiments without departing from the scope of the present disclosure. 
     Although the figures may show a specific order of method steps, the order of the steps may differ from what is depicted. Also two or more steps may be performed concurrently or with partial concurrence. Such variation will depend on the software and hardware systems chosen and on designer choice. All such variations are within the scope of the disclosure. Likewise, software implementations could be accomplished with standard programming techniques with rule-based logic and other logic to accomplish the various connection steps, processing steps, comparison steps, and decision steps. 
     While the disclosure has been described in connection with certain embodiments, it is to be understood that the disclosure is not to be limited to the disclosed embodiments but, on the contrary, is intended to cover various modifications and equivalent arrangements included within the scope of the appended claims, which scope is to be accorded the broadest interpretation so as to encompass all such modifications and equivalent structures as is permitted under the law.