Japan has been at the forefront of many trends, particularly in technology. Bullet trains, pocket calculators, the Walkman, LED lights and, errr, emojis.
It is also at the forefront of ageing: with a median age of 46.9 years, Japan is the oldest among any major nation.
The future, for forward-thinking investors, should be the intersection of tech and aging.
The medical and long-term-care market in Japan is worth ¥50 trillion ($445 billion), give or take a few. Give, more than likely.
Multiply health care and IT&C, and you may just get a new industry, according to a new report from the Japanese investment bank Nomura (NMR) .
There are four main areas of technical excellence in the making: telemedicine, artificial intelligence, robotics and online-service platforms that face both patients and medical professionals.
As the population as a whole becomes older, it's necessary for health care to advance out of the hospital and clinic and into the wider world. Investors can benefit from the broader reach of medicine as the pharmacy, consulting room, care home and even operating theater breach their four walls and go global.
Japan's median age is heading toward 50 fast. It's in fact second only globally to that tiny haven of the super-rich, Monaco. The "normal" Monegasque tax exile is not only phenomenally wealthy, but also 52.4 years wise.
This presents plenty of challenges to Japan, where there simply aren't enough workers to go around in many industries. All-day restaurants are cutting night hours or even offering college scholarships to lure employees.
But it presents opportunities for companies that are able to apply technology to the health-care industry. They can now bring services to the mass market that once you could only imagine in specialty care. And for professionals, online medical platforms store endless amounts of documents.
Take Fronteo (FTEO) . The company is applying its proprietary system for artificial intelligence, known as KIBIT, to health care. KIBIT (which can also find you the best place to grab a bite of Mexican, or which piece of vampire lit you might enjoy) is designed to "learn" from existing medical knowledge, adjusting as expert journals publish research.
This can be applied to pain care or to mitigate the risk of falling, accomplishing some front-line tasks to free up overworked flesh-and-blood medical workers to focus on their own area of expertise.
At ¥28 billion ($248 million) in market capitalization, it's one of the smallest companies identified by Nomura as being at the vanguard of Japan's med-tech new wave. But it's in one of the areas that's probably most exciting in terms of potential scope and impact.
Ship Healthcare Holdings T:3360 supplies modular Flex-Dock operating rooms that are custom-made to order. It also provides SCOT, the "smart cyber operating theater," that deploy robotics.
Cyberdyne (CYBQY) creates robotic exoskeletons. HAL 5, which stands for the "hybrid assistive limb" system, is a lot more cooperative than the HAL 9000 that wouldn't help Dave in 2001: A Space Odyssey. HAL, in 2017, is designed to augment human movement and assist, for instance, those afflicted by traumatic spinal injuries.
More "I'm afraid I can do that," then. Saudi Arabia, keen to bolster its reputation as one of the best health-care centers in the world, looks to be the first overseas nation to welcome an active HAL to its shores.
Tokai T:9729 brings a splash of green to the silver wave. Its Nexsurg sterilized surgical linens can be re-used. That promises to reduce some of the ecological disaster that appears to be every interaction you have with the health care system in its turn-of-the-21st century form. The company also operates the Tanpopo pharmacy and dispensing chain.
SMS T:2175 provides job sites, student-nurse recruitment, online professional registration, and search functions for professionals such as nutritionists. It also operates online communities for those working in medical fields. Its online job sites include Kaipoke, Kaigo and Job.
M3 T:2413 operates various online medical portals for health-care professionals, medical companies and the general public. Its various functions, mainly industry-facing, support clinical trials, help medical professionals with career changes and job support, and conduct medical surveys. Backed some 40% by Sony, it also makes its own venture-capital investments.
It has around 3.5 million doctors who are users in Japan, the United States and China. Its AskDoctors Q&A site allows doctors to answer patient questions, with a collaboration with family doctors that offers a ¥15,000 ($133) consultation for 30 minutes that includes a second opinion.
Medical Data Vision T:3092 is a company that creates data networks. It provides medical management-analysis systems such as EVE for hospitals and health-insurance unions. Its aggregated patient data is used in epidemiological studies, too.
Kanamic Network T:3939 operates an information-sharing platform Kanamic iCloud for doctors and nurses. It's used by some 18,000 medical companies and around 70,000 medical professionals. Kanamic then sells advertisements against some of the content. The company also runs support systems for child care and care for the elderly.
CE Holdings T:4320 is one of the smallest of the companies identified in the Nomura report, at just ¥5 billion ($45 million) in market cap. Its electronic medical-records system sells under the MI.RA.IS package to medical institutions. Its software tracks health records but also medical accounting and ordering, and is used for checkup appointments and blood-transfusion records at public hospitals.
Secom (SOMLY) is an established giant, at ¥1.9 trillion ($17 billion) in market cap, to the atom size of CE Holdings. It has its origins in security, at first providing guards and patrol services in the 1960s, then gravitating into CCTV and remote security. Secom offers cloud-computing forms of storing electronic medical records, as well as the management information-analysis system SMASH.
My Doctor Plus is a consumer product, a GPS-enabled mobile device like a smartphone. It's linked to a nurse center, with an alarm function, that also stores your medical records such as medications taken, blood type, treatment history and family details.
There are gaps to bridge. Japan's middle- and old-age population may have the money and incentive to pay for medical care, but they are also the part of the populace that is generally the least tech-savvy. They may be the most concerned over perceived and very real risks of breaks in communication, leaks of personal data, or simple problems with the transmission of data.
Doctors aren't always the first to grasp new non-medical technology, either. A resistant and hidebound profession at times, the industry also responds to the direction of medical fees and government grants, neither of which are fully supportive of the development of med-tech in Japan.
Yet, those are surely positions that will change. The United States stole an advance in med-tech after the financial crisis. But Prime Minister Shinzo Abe's administration is responding, with formation of entities like the Council on Next-Generation Medical ICT Infrastructure and the broader Council on Investments for the Future.
Germany and Italy are not far behind Japan in terms of a populace that is graying at the temples. So the lessons learned socially and applied technologically in surfing the "silver demographic wave" will translate very well to other Western nations.