Method and system for verifying the optimal placement of body sensors

Abstract

A system is disclosed comprising a monitoring patch configured to be attached to the skin of a relevant patient, the monitoring patch comprising at least one vital sign sensor positioned to measure vital sign data of the relevant patient when the monitoring patch is attached to the skin of the relevant patient. The monitoring patch comprises a wireless transceiver or transmitter configured to wirelessly transmit vital sign data; a monitoring device configured to receive the wirelessly transmitted vital sign data and to store, retransmit, or both store and retransmit the vital sign data; a skin condition sensor configured to measure skin measurement data of the relevant patient's skin; and at least one hardware processor configured to analyze the skin measurement data to determine advice regarding the attachment of the monitoring patch to the skin and to output such advice on the monitoring patch or monitoring device.

Description

Technical Field

[0001] This patent application claims priority under 35 U.S.C. § 119 to U.S. Provisional Patent Application No. 63 / 456,056, filed on Mar. 31, 2023, the content of which is incorporated herein by reference.

[0002] The following generally relates to medical monitoring technology, wearable medical monitoring technology, heart rate monitoring technology, patient activity monitoring technology, and related technologies.

Background Art

[0003] Unobtrusive health detection systems enable the replacement of continuous hospitalization centered on the individual with prominent vital sign sensor technology and provide remote monitoring of the general health status of subjects. Such systems can also be used for other purposes, such as diagnosing heart conditions, screening medical conditions, etc. Monitoring of vital signs typically includes monitoring one or more of physical parameters, namely heart rate (HR), blood pressure (BP), respiratory rate (RR), core body temperature, and blood oxygenation (SpO2).

[0004] Current portable ECG monitors and mobile cardiac telemetry systems collect ECG data in an outpatient setting (e.g., the patient's home environment or outdoors). In such systems, the patient places a sensor as a patch on their chest. This sensor communicates wirelessly with a dedicated mobile device, similar in form factor to a smartphone, which is connected to a clinical service center via the internet. In other embodiments, the sensor may be directly connected to the internet, or it may utilize an application program ("app") that runs on a general-purpose smartphone. Some examples of such devices include the ePatch (extended Holter ECG monitor) and MCOT (mobile cardiac telemetry) devices available from Philips BioTel. These devices provide a wearable, disposable electrode patch to which an electronic module is attached to form a patient-worn device. This electronic module is advantageously reusable for at least a given patient.

[0005] With the current advancements in wearable technology and connected platforms, remote patient monitoring has become a preferred approach for collecting field data for both diagnosis and treatment. A key aspect of remote patient monitoring is the attachment and activation of sensing technologies for data acquisition. Typically, such attachment and activation are performed by the patient themselves. Appropriate guidance in this process is crucial for the quality of the remote patient monitoring system.

[0006] Many wearable sensors acquire their measurements through contact with the skin. In this case, the patient should be guided not only to prepare the skin on that part of the body, but also to attach the sensor to the appropriate location on the body so that contact is optimal. Certain properties of the skin, such as sebum levels (i.e., oiliness) or hair density, may hinder the proper attachment of the wearable to the skin. The patient should prepare the skin so that adhesion is optimal. The patient then needs to attach the wearable to the skin so that the contact between the relevant sensor and the skin is sufficient and optimal. [Overview of the Initiative] [Problems that the invention aims to solve]

[0007] In most cases, patients are unfamiliar with the installation and activation of remote monitoring technology. Furthermore, patients tend to experience stress when they have to go through this process due to their health condition.

[0008] The following discloses specific improvements to overcome these and other problems. [Means for solving the problem]

[0009] In one embodiment, the system includes a monitoring patch configured to be attached to the skin of a relevant patient. The monitoring patch includes at least one vital sign sensor positioned to measure vital sign data of the relevant patient when the monitoring patch is attached to the skin of the relevant patient. The monitoring patch further includes a wireless transceiver or transmitter configured to wirelessly transmit the vital sign data. A monitoring device is configured to receive the wirelessly transmitted vital sign data and to store, retransmit, or both store and retransmit the vital sign data. The skin condition sensor is configured to measure skin measurement data of the relevant patient's skin. At least one hardware processor is configured to analyze the skin measurement data to determine advice regarding the attachment of the monitoring patch to the skin and to output this advice on the monitoring patch or the monitoring device.

[0010] In another embodiment, a health condition monitoring method includes measuring skin measurement data of the skin of a related patient using a skin condition sensor attached to the skin of the related patient, analyzing the skin measurement data using at least one hardware processor to determine advice regarding the attachment of a monitoring patch to the skin, and outputting the advice.

[0011] One advantage is that it provides a reliable remote monitoring system for monitoring patients.

[0012] Another advantage is that the patient monitoring system can be securely attached to the patient's skin.

[0013] Another advantage is that it is an easily attachable, wearable patient monitoring device, thereby reducing patient stress.

[0014] Another advantage lies in determining the condition of the patient's skin to be suitable for attaching a wearable patient monitoring system to the patient's skin.

[0015] A given embodiment may not provide any of the above-described advantages, may provide one, two, more, or all of them, and / or may provide other advantages that will become apparent to those skilled in the art upon reading and understanding this disclosure. [Brief explanation of the drawing]

[0016] This disclosure may take the form of various components and arrangements thereof, as well as various steps and arrangements thereof. The drawings are intended merely to illustrate preferred embodiments and should not be construed as limiting this disclosure. [Figure 1] Figure 1 schematically shows an exemplary embodiment of the patient monitoring system according to this disclosure. [Figure 2] Figure 2 schematically shows an exemplary embodiment of the patient monitoring system according to this disclosure. [Figure 3] Figure 3 schematically shows an exemplary embodiment of the patient monitoring system according to this disclosure. [Figure 4] Figure 4 shows an illustrative flowchart of the operations performed appropriately by the system in Figure 1. [Figure 5] Figure 5 shows an illustrative flowchart of the operations performed appropriately by the system in Figure 1. [Modes for carrying out the invention]

[0017] As used herein, unless otherwise explicitly stated in the context, the terms include the presence of multiple parts or components, even if they are not explicitly stated as such. As used herein, the expressions “joined,” “connected,” or “engaged” of two or more parts or components mean that, insofar as they are interlocked, these parts are joined, operate, or cooperate directly or indirectly, i.e., through one or more intermediate parts or components. For example, but not limited to, directional expressions used in the specification, such as top, bottom, left side, right side, up, down, front, back, and their derivatives, relate to the orientation of elements shown in the drawings and do not limit the scope of the claimed invention unless otherwise explicitly stated. The terms “have” or “include” do not exclude the presence of elements or steps other than those described herein and / or enumerated in the claims. In a device composed of several means, some of these means may be embodied by identical items of hardware.

[0018] The disclosed system focuses on the placement of a body-worn sensor (referred to herein as a patch) that requires thorough preparation, such as removing body hair and cleaning the skin (i.e., removing any lotions and oils from the skin). Inadequate skin preparation significantly impacts both the quality of patch placement (resulting in improper adhesion to the body) and the quality of data acquisition. However, it is unclear to the patient whether the preparation is sufficient to achieve the desired quality for a remote monitoring system. The disclosed system assesses the quality of skin preparation during patch placement via the sensor and provides direct feedback to the patient if further preparation measurements are required. In addition, several embodiments of the disclosed system are used to monitor over time whether the patch is properly attached.

[0019] Several exemplary embodiments utilize a galvanic skin response (GSR) sensor, which comprises electrodes in contact with the skin (e.g., Ag / AgCl electrodes, which may have an adhesive) and a low-voltage or current source that applies a voltage or current to these electrodes to measure the electrical resistance (or conductance, which is the reciprocal of resistance) of the skin between the electrodes. GSR sensors are commonly used to assess mental state (e.g., stress) because certain emotions stimulate the autonomic nervous system to increase sweating, thereby increasing the electrical conductivity of the skin (i.e., decreasing the electrical resistance of the skin). Thus, GSR sensor measurements can provide biofeedback for monitoring mental state, for example, to indicate when a user's stress level is high. GSR sensors are sometimes integrated into smartwatches to provide the wearer with real-time feedback on their mental state.

[0020] As described herein, the GSR sensor is used for another purpose, namely, to assess whether skin is properly prepared for placement of a heart rate monitoring device. The GSR sensor measurement is performed immediately after skin preparation. One proper skin preparation sequence involves thoroughly washing the skin with soap, then drying it, and then further scrubbing the skin using a scrub pad. Therefore, the GSR sensor measurement performed immediately after skin preparation provides a quantitative assessment of whether the skin preparation was sufficient to remove any sweat, oil, or sebum, etc., to ensure good electrical contact between the prepared skin and the heart rate monitor.

[0021] Referring to FIG. 1, a system 1 for monitoring a related patient P is shown. As used herein, the term "patient" (and variations thereof) refers to an outpatient, a discharged patient, a patient undergoing an examination using a monitoring device as part of an annual health check, or any other person whose health condition is to be monitored, including them. As shown in FIG. 1, the system 1 includes a wearable monitoring device 10 that can be worn by the patient P or attached to the patient P in another way (i.e., adhesively attached). The wearable monitoring device 10 can include any suitable monitoring device, for example, a mobile cardiac outpatient telemetry (MCOT) device (available from Philips ECG Solutions in Malvern, Pennsylvania, USA), or a medical wearable device, a body-worn vital sign health patch, a wristwatch, a chest strap, smart clothing, a medical plug-in / ear-covering earphone, a forehead or nose sensor, or a smart ring, etc.

[0022] More generally, the wearable monitoring device 10 can include one or more sensors configured to measure physiological sensor data of the patient P wearing the monitoring device 10. As shown in FIG. 1, the monitoring device 10 includes two sensors, namely, a vital sign sensor 12 (referred to herein as the ECG sensor 12), and a galvanic skin response (GSR) sensor 14. The ECG sensor 12 is configured to measure the heart data 13 of the patient P (for example, having skin contact electrodes with a silver / silver chloride coating). The GSR sensor 14 is configured to measure the skin condition of the patient P where the monitoring device 10 is placed (for example, having skin contact electrodes with a silver / silver chloride coating).

[0023] An exemplary wearable monitoring device 10 includes a disposable electrode patch 11 having one or more vital sign sensors 12 (which may also be embodied as, for example, one or more electrodes 12) configured to measure vital sign data 13 of patient P when the monitoring device 10 is attached to the skin of patient P. The vital sign sensors 12 may implement other types of vital sign sensors (e.g., blood pressure sensors, lung sensors, SpO2 sensors, electroencephalogram (EEG) sensors, etc.), but may have an electrocardiogram or heart rate monitor configured to measure cardiac data 13. Similarly, a GSR sensor 14 (embodied as, for example, an electrode 14) is configured to measure skin measurement data 15 of the patient P's skin. The electrode 14 is integrated with the monitoring device 10 within the same patch 11 and can be positioned to make electrical contact with the skin when the monitoring device 10 is attached to the skin of patient P.

[0024] Exemplary monitoring device 10 includes an electronic module 16 attached to an electrode patch 11, and a vital sign sensor 12 may be incorporated into this electronic module 16. In the exemplary FIG. 1, the electronic module 16 includes, for example, a heart rate (HR) module 17 having a sample-and-hold and an analog-to-digital (ADC) circuit for obtaining digital heart rate (HR) samples. The electronic module 16 optionally further includes at least one microprocessor or microchip (not shown) configured (e.g., programmed) to preprocess the heart signal from the heart sensor (electrode) 12 to generate heart data 13. The device 10 including the electrode patch 11 and the attached electronic module 16 is adhered and fixed to the chest or other anatomical structure of the patient P after appropriately cleaning the skin. The use of a separate electrode patch 11 and the electronic module 16 advantageously enables a low-cost configuration where the more expensive electronic module 16 is reused while the disposable electrode patch 11 can be replaced as needed during the patient's monitoring period (which may span several days or weeks). However, other configurations are also conceivable, such as configuring the patch 11 and the electronics 16 as a unitary disposable unit. Although not shown, it is also understood that the wearable monitoring device 10 may include a built-in battery or another built-in power source for powering the electronic module 16. This built-in battery may be integrated with the electronic module 16 including, for example, a charging port connector for charging the electronic module 16, or the electronic module 16 can be placed on a wireless inductive charging station to charge the electronic module 16 if necessary during the patient's monitoring period.

[0025] The wearable monitoring device 10 also includes a schematicly shown wireless transmitter or transceiver 18 (hereinafter referred to as transceiver 18), which is optionally integrated with the electronic module 16. The transceiver 18 is integrated with the monitoring device 10 or communicates wirelessly with the monitoring device 10 and transmits patient data (e.g., cardiac data 13 and skin measurement data 15) to a monitoring device 20 configured to receive wirelessly transmitted vital sign data 13, store this vital sign data 13, retransmit it, or both store and retransmit it. As shown in Figure 1, the monitoring device 20 has a mobile device 20 that can be operated by the patient P or the clinician monitoring the patient P. In some embodiments, the electronic processor 16 is configured to collect cardiac data 13 from the ECG sensor 12 and / or skin measurement data 15 from the GSR sensor 14 and the GSR module 21 included in the electronic module 16, and optionally preprocess the data, and the transceiver 18 is configured to transfer the cardiac data 13 and / or skin measurement data 15 to a mobile device 20 (e.g., a mobile phone or other smart device, or a dedicated medical monitoring device) that can be operated by the patient P. In a typical configuration, the transceiver 18 is a low-power wireless transceiver (e.g., Bluetooth®, Zigbee®, etc.) that connects to the mobile device 20 with low power, thus reducing the power consumption of the built-in battery of the wireless monitoring device 10.

[0026] Using an intermediate mobile device 20 has several advantages, such as having a display 23 that can show a user interface (UI) 24 to present a log for the patient to record health symptoms. Instead of processing some or all of the cardiac data 13 and accelerometer data 15 in the built-in electronic module 16 of the wearable monitoring device 10, the mobile device 20 can also perform that processing. However, alternatively, the separate mobile device 20 can be omitted, and instead, all processing can be performed by the electronic module 16 of the wearable monitoring device 10, and the transceiver 18 of the wearable monitoring device 10 can communicate wirelessly directly with the clinical health information system 22. In such an embodiment, the wearable monitoring device may also include a display for presenting the user interface 24, and for example, the wearable monitoring device 10 may have the form factor of a wristwatch.

[0027] In some embodiments, as shown in Figure 1, the monitoring device 10 includes a vital sign sensor 12, an electronic processor (i.e., an internal electronic processor) 16, and a wireless transceiver 18, which are arranged in a patch 11 that can be attached to a portion of the patient P, and a GSR sensor 14 is connected to an electronic module 16, which is included in the same patch and further programmed to perform GSR measurements. For this purpose, the electronic module 16 includes a schematically shown GSR module 21, which has an ohmmeter (W) configured to apply a voltage (V) to the GSR electrodes 14 and measure the current (I) flowing through the portion of skin arranged between these GSR electrodes 14. In this case, the measurement of GSR is given by the ratio I / V. In an alternative approach, the GSR may be measured as a conductance value, i.e., I / V. In this specification, GSR should be understood to include either a measurement of electrical resistance (V / I) or conductance (I / V). Furthermore, the GSR module 21 may be configured to apply a current (I) and measure a voltage (V) instead. In either case, the built-in battery or other built-in power source that supplies power to the electronic module 16 can adequately power the GSR module 21 to deliver the applied voltage (V) or current (I) to the GSR electrode 14, thereby enabling GSR measurement.

[0028] Continuing to refer to Figure 1, and further to Figure 2, in another embodiment, the same electrodes are used for both measuring heart rate (or other vital signs) and GSR. Figure 2 shows a separated diagram of such an alternative embodiment, which shows only the electronic module 16 and electrodes 12-14 used in this embodiment for both measuring GSR and heart rate (HR). In this embodiment, since the voltage (or current) applied during GSR measurement may interfere with ECG measurement, the heart rate module 17 should not measure heart rate while the GSR module 21 is measuring GSR. Therefore, as schematically shown in Figure 2, the electronic module 16 in this embodiment includes a switch 30 for switching between (i) electrodes 12-14 connected to the heart rate monitor 17 (but not to the GSR monitor 21) and (ii) electrodes 12-14 connected to the GSR monitor 21 (but not to the heart rate monitor 17). This switch 30 can be implemented as a MOSFET switch or the like.

[0029] In the embodiment of Figure 1, which uses separate HR electrodes 12 and GSR electrodes 14, it may be possible to measure both HR and GSR simultaneously, depending on factors such as how far the HR electrode 12 is from the GSR electrode 14 and the power (voltage or current) applied during GSR measurement. If GSR may adversely affect HR measurement, the processor of the electronic module 16 can be programmed to stop HR measurement while GSR measurement is in progress.

[0030] In yet another embodiment, as shown in Figure 3, the monitoring device 10 includes a vital sign sensor 12, an electronic processor (i.e., an internal electronic processor) 16, and a wireless transceiver 18, which are located on a patch 11 that can be attached to a first part of patient P, and a GSR sensor 14 located on a second separate patch 19 that can be attached to a second part of patient P. The second patch 19 also includes a GSR module (not shown in Figure 3) and a power supply 21 connected to apply current or voltage to the GSR electrode 14 to measure skin measurement data 15. In one embodiment, the internal electronic processor 16 is located on the first patch 11 and is configured to control the vital sign sensor 12 to acquire vital sign data 13 using the vital sign electrode 12. In another embodiment, the internal electronic processor 16 is located on the second patch 19 and is configured to control the GSR sensor 14 to acquire skin measurement data 15 using the GSR electrode 14. In another embodiment, the GSR electrode 14 is the same set of electrodes as the vital sign electrode 12. In this embodiment, the built-in hardware processor 16 controls the operation of the vital sign sensor 12 and the GSR sensor 14 so that when the GSR sensor is operating to acquire GSR skin measurement data 15, the vital sign sensor 12 is not used to measure vital sign data 13.

[0031] Once data is acquired, the hardware processor 16 (or alternatively, the monitoring device 20) is configured to analyze the skin measurement data 15 to determine advice regarding the adhesion and attachment of the monitoring patch 10 to the patient P's skin, and to output this advice onto the monitoring patch 10 or the monitoring device 20. In some examples, the advice includes recommendations regarding whether the skin is adequately prepared for adhesion and attachment of the monitoring patch 10. In other examples, the advice includes the estimated remaining operating time of the monitoring patch 10 after adhesion and attachment to the skin (i.e., due to decreased adhesion or deterioration of electrode contact with the skin).

[0032] In one example, the advice is output on the GUI 24 of the mobile device 20. In another example, a second patch 19 further includes a light-emitting diode 25, and a hardware processor 16 is configured to operate the LED 25 in a first state if the skin is properly prepared, and in a second state different from the first state if the skin is not properly prepared. For example, the LED 25 may be illuminated or not illuminated to indicate whether the skin is properly prepared to patient P. In another example, if the skin is properly prepared, the LED 25 may be illuminated in a first color (i.e., green), and if the skin is not properly prepared, the LED 25 may be illuminated in a second color (i.e., red).

[0033] As further schematicly shown in Figures 1 and 3, the electronic processor 16 is configured to perform a health status monitoring method 100 that monitors patient P by analyzing cardiac data 13 and / or skin measurement data 15.

[0034] Referring here to Figure 4, an exemplary embodiment of the health monitoring method 100 is shown as a flowchart. To initiate this method 100, a second patch 19 including a GSR sensor 14 is attached to patient P. In operation 102, the electronic processor 16 is configured to control the GSR sensor 14 to acquire skin measurement data 15. In operation 104, the electronic processor 16 is configured to analyze the skin measurement data 15 and, based on this skin measurement data 15, determine advice regarding the attachment of a monitoring patch 10 (i.e., a patch 11 including a vital sign sensor 12) to the skin. In operation 106, the electronic processor 16 is configured to output the advice (for example, by controlling an LED 25 on the GUI 24 of a mobile device 20). In operation 108, when the advice indicates that the skin is properly prepared for attachment of the monitoring patch 10, the patch 11 is attached to patient P's skin and the vital sign sensor 12 is configured to acquire vital sign data 13.

[0035] Figure 5 shows another example of the flowchart for method 100. Operation 102 is shown as the “GSR evaluation” process. In operation 103, the electronic processor 16 performs a signal processing operation on the skin measurement data 15. If the signal processing operation 103 determines that the skin measurement data 15 is not OK, operation 104 is performed and advice to reposition the patch 19 is output in operation 106 (i.e., the “correction feedback” process). If the signal processing operation 103 determines that the skin measurement data 15 is OK, operation 104 is performed and advice to affix the patch 11 to the patient P’s skin is output in operation 106 (i.e., the “placement feedback” process). Next, the vital sign sensor 12 is attached to the skin and operation 108 (i.e., the “patch activation” process) is performed in which the sensor measures vital sign data.

[0036] In some embodiments, the GSR placement sensor 14 is implemented on a separate device (i.e., a second patch 19). This device 19 can be used before actually attaching the wearable monitoring patch 10 to check that the skin is sufficiently prepared.

[0037] The GSR skin measurement data 15 is processed to determine whether the skin preparation is sufficient to ensure that the monitoring patch 10 adheres to the skin for the intended period and does not peel off prematurely.

[0038] In some embodiments, the GSR measurement data 15 is used to predict the expected duration of adhesion from the current measurement so that the patient P (or physician) can determine whether it is sufficient for the current purpose.

[0039] In some embodiments, the monitoring patch 10 may include additional sensors that help predict the adhesion quality / duration of the patch 10.

[0040] In other embodiments (e.g., Figures 1 and 2), the GSR sensor 14 is integrated into the monitoring patch 10 itself. In this case, the above function for checking whether the skin is adequately prepared is still appropriate, but if it is not prepared, it is not easy to remove the wearable monitoring device again. Nevertheless, it is a good check before the patient begins the measurement period in which they wear the monitoring patch 10.

[0041] When the GSR sensor 14 is incorporated into the monitoring patch 10 (for example, Figure 1 or Figure 2), the GSR sensor 14 can check whether the monitoring patch 10 is in sufficient contact with the skin. This measurement can be performed after the monitoring patch 10 has been attached but before the measurement of vital sign data 13 begins. This still allows for the reapplication or replacement of the current patch 11.

[0042] Measurements may also be performed periodically during the wearing period of the monitoring patch 10 to ensure that patch 11 is still properly adhered. If it is not properly adhered, the patient will be warned to reapply or replace patch 11. Since the connection measurement is performed by GSR, this measurement involves applying a small current / voltage to the skin to measure skin resistance. The application of this measurement current may interfere with the primary measurement of the monitoring patch 10. Therefore, the electronic processor 16 adjusts when the GSR-based skin contact measurement 15 is performed and also adjusts not to perform the vital sign measurement 13 during the GSR measurement 15 (because the GSR measurement is unreliable and may affect the processing of the vital sign measurement 13).

[0043] In the exemplary embodiment, the skin condition sensor 14 is a GSR sensor 14 that acquires GSR measurements as resistance (V / I) or conductance (I / V) values. However, other types of skin condition sensors are also possible. For example, instead of the exemplary GSR sensor, a Sebumeter® can be used. The Sebumeter® performs light reflectance measurements to detect sebum (oil) on the skin.

[0044] This disclosure has been described with reference to preferred embodiments. Others may come up with modifications and changes based on reading and understanding the detailed description above. The exemplary embodiments are intended to be construed as including all such modifications and changes, to the extent that such modifications and changes fall within the scope of the appended claims or their equivalents.

Claims

1. A monitoring patch configured to be attached to the skin of a related patient, the monitoring patch further comprising at least one vital sign sensor positioned to measure vital sign data of the related patient when the monitoring patch is attached to the skin of the related patient, and a wireless transceiver or transmitter configured to wirelessly transmit the vital sign data, A monitoring device configured to receive the vital sign data transmitted wirelessly, store the vital sign data, retransmit it, or both store and retransmit it, A skin condition sensor configured to measure skin measurement data of the skin of the aforementioned patient, At least one hardware processor and In a system having, the at least one hardware processor is Analyzing the aforementioned skin measurement data to determine advice regarding the attachment of the monitoring patch to the skin, The aforementioned advice is output on the monitoring patch or the monitoring device. A system configured to perform the following actions.

2. The system according to claim 1, wherein the advice includes recommendations regarding whether the skin is adequately prepared for the attachment of the monitoring patch to the skin.

3. The monitoring patch includes an LED, and the at least one hardware processor is The system according to claim 2, configured to output the advice regarding whether the skin is properly prepared for adhering and attaching the monitoring patch to the skin by operating the LED in a first state if the skin is properly prepared, and in a second state different from the first state if the skin is not properly prepared.

4. The system according to claim 1, wherein the advice has an estimated remaining operating time of the monitoring patch attached to the skin.

5. The system according to claim 1, wherein the skin condition sensor is integrated with the monitoring patch and includes an electrode arranged to electrically contact the skin when the monitoring patch is attached to the skin of the associated patient.

6. The system according to claim 1, wherein at least one vital sign sensor has an electrocardiogram or a heart rate monitor.

7. At least one hardware processor includes an internal hardware processor that is integrated with the monitoring patch or configured to be attached to the monitoring patch, The aforementioned skin condition sensor is A galvanic skin reaction (GSR) sensor comprising a GSR electrode, which is integrated with the monitoring patch and is positioned to electrically contact the skin when the monitoring patch is attached to the skin of the associated patient, and a power supply connected to apply current or voltage to the GSR electrode, The system according to claim 1, wherein the GSR sensor further comprises the built-in hardware processor configured to acquire the skin measurement data having GSR data using the power supply and the GSR electrode.

8. The at least one vital sign sensor is integrated with the monitoring patch and includes a vital sign electrode positioned to make electrical contact with the skin when the monitoring patch is attached to the skin of the associated patient. The system according to claim 7, wherein the at least one vital sign sensor further comprises the built-in hardware processor configured to acquire the vital sign data using the vital sign electrode.

9. The system according to claim 8, wherein the GSR electrode is the same set of electrodes as the vital sign electrode.

10. The system according to claim 9, wherein the built-in hardware processor is configured to control the operation of the vital sign sensor and the GSR sensor so as not to use the vital sign sensor to measure vital sign data when the GSR sensor is operating to acquire the GSR data.

11. The system according to claim 1, wherein at least one sensor includes a galvanic skin response (GSR) sensor configured to measure the condition of the skin of the associated patient on which the monitoring device is placed.

12. The monitoring device comprises a vital signs sensor, the electronic processor, and a wireless transmitter or receiver located on a patch that can be attached to the relevant portion of the patient, wherein the GSR sensor is located on a second separate patch that can be attached to the relevant portion of the patient, according to claim 11.

13. Using a skin condition sensor attached to the skin of the relevant patient, skin measurement data of the relevant patient's skin is measured, Using at least one hardware processor, analyze the skin measurement data to determine advice regarding the attachment of the monitoring patch to the skin, Outputting the aforementioned advice A method for monitoring health status, comprising [specific features / features].

14. The method according to claim 13, wherein the measurement includes measuring the condition of the monitoring patch attached to the skin of the relevant patient.

15. The method according to claim 13, further comprising measuring vital sign data of the associated patient when the monitoring patch is attached to the skin of the associated patient, using at least one vital sign sensor placed on the monitoring patch.

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