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In the days leading up to the attack, there are a series of subtle warning signs…

A slight rise in body temperature.

Disturbed sleep.

A variable heart rate.

Many of these signs are so subtle that you barely notice them.

But slowly the body begins to react…

Your blood pressure spikes.

When you lay down at night, you may be repeatedly jolted out of sleep as heart pumps proteins into your bloodstream.

This can happen for two or three days, but very few people seek medical attention.

We tend to wait for the attack itself.

And it’s always sudden…

An uncomfortable pressure grips the center of the chest. Sharp pain shoots through the arm, neck and clamping jaw. Breath shortens.

What next?

A recent report by the US Centres for Disease Control and Prevention discovered that about 47% of cardiac deaths happen before the victim reaches the hospital.

However over the last few years, I’ve been tracking medical devices that can spot the early signals of crises such as heart attacks.

And there are some hugely promising devices – and opportunities for investors.

Take the SensAheart (pictured below).

It’s a very simple device roughly the size of a USB stick, which is as easy to use as a blood sugar or pregnancy test and just as quick.

Placing a drop of blood on a testing strip.

The device checks for evidence of a reaction between two types of proteins — HFABP and troponin – and any antibodies your body might produce in the lead up to a heart attack.

Existing blood tests can take up to six hours to deliver a result, after a patient shows symptoms of a heart attack.

This one takes roughly five minutes for results.

The device is the brainchild of Emil Katz, founder and CEO of Novamed, a life-sciences company that makes medical products, who was alarmed at how quickly a number of his friends suddenly died from heart attacks.

It’s already used in Israel and many hospitals in Europe.

“If that patient comes into the hospital with a positive test, said Dr. Chaim Lotan, of the Hadassah Ein Kerem Medical Center in Jerusalem, “they will be a priority, because we will believe with a very high certainty that something is wrong with his heart.”

“Time is muscle. We know the heart muscle can live without blood for four to six hours, so if you are opening the artery after four hours, there will be a lot of damage to the heart.

“If you open the artery early, you can save a lot of muscle.”

Britain’s Aging Timebomb 

These devices have a huge addressable market.

A recent study by Newcastle University concluded that within 20 years more than two million Britons will be living with four or more chronic illnesses due to years spent living a sedentary lifestyle.Although life expectancy is set to increase by 3.6 years for men and 2.9 years for women, “two-thirds of this extra time is likely to be marred by disease”.

The knee jerk reaction is to continue to spend an enormous amount on the NHS.

But this is not sustainable…

The UK is aging…
The Potential Support Ratio (PSR), a measure of amount of working people (15-64) for each person over 65+ in age, is anticipated to fall below 5.0 in Japan, Italy, Germany, Canada, France, and the United Kingdom over the next decade.

These countries will all have significant portions of their populations (>30%) made up of elderly people by 2050.

We can no longer continue to scale up our services to cope with looking after a rapidly aging population.

Remote Monitoring: A new $15bn industry

I see immediate solutions and opportunities in this field.

The first is to make cheap, wearable devices that can help patients – especially with chronic conditions – to monitor their conditions themselves.

Preventable hospital readmissions cost Medicare and Medicaid $17 billion in 2014, according to the US Department of Health and Human Services.

Heart failure was one of the worst offenders.

A quarter of the 5.1 million people afflicted annually end up back in the hospital with thirty days of discharge.

Instead of rushing to A&E, waiting for hours for treatment…

Instead of waiting weeks for doctors appointments, only to be given antibiotics…

We’ll rely on cheap reliable devices and mobile phone apps to give us well timed and accurate advice on managing our medical conditions.

A company such as Sentrian, for example, has a number of wearable devices that collect data such as heart rate, blood pressure, oxygen, and feeds them to an online platform where machine-learning algorithms detect subtle patterns in chronic conditions such as heart disease, diabetes and pulmonary diseases.

BeVITAL, made by Vital Conect, is a thin, disposable patch like a band-aid that you stick to your chest.

It tracks heart activity, breathing rate, temperature, physical movement, posture, and even falls.

The patch can stream vital signs to doctors offices and send out warning signals, sometimes weeks in advance, before serious problems begin.

As the price of wearable healthcare devices falls, patients will carry biosensors – on their smartphones or on an adhesive behind the ear – with the kind of sophisticated technology that used to only be available in intensive care.

Goldman Sachs says a digital healthcare revolution is coming — with a brand new $15bn opportunity in remote monitoring alone.

And there are many other areas of this market that look promising: not least the use of Artificial Intelligence is monitoring our health.

In recent years, this entire field has come to be known as “Gerontechnology” – the application of technology to the treatment of aging.

And it’s huge investment theme…

The coming boom in Gerontechnology 

You only have to look at Japan to see the scale of the opportunity.

Japan, aging faster than any other country in the world, is staring down a demographic crisis of unprecedented scale. A plummeting fertility rate – just 1.39 children per woman – isn’t nearly enough to balance out annual deaths.

The population is expected to fall from its current 127 million people to just 87 million by 2060. By then, more than 40 percent of Japanese will be aged 65 or older.

Japan is anticipating this monumental restructuring of society.

And so for the last two decades they have been investing heavily in gerontechnology.

This famously includes smart toilets: which speak to you, but also give you an accurate read out of your health, based on the bacteria you deposit.

Meanwhile, Japan has been working for years to develop a generating of robotic caretakers with Toyota, Honda and Tokai Rubber Industries leading the field.

For example, Tokai has developed a robot resembling a large smiling bear with soft skin that can pick up and set down humans weighing up to 175 pounds.

Softbank robotics pioneer Masayoshi Son says that he expects there to be more robots than humans within 30 years with IQ’s of 10,000.

Cyberdene recently introduced the world’s first advanced robotic treatment device  – HAL as in Hybrid Assisted Limb – a very advanced “exoskeleton” for patients with spinal cord injuries.

How it works…

*Sensors attach to the patient’s lower extremities.

*When the patient intends to move, muscles receive nerve signals from the brain, and faint bio-electrical signals are detected on the skin’s surface.

*HAL then uses sensors to detect these signals and assists with any desired movements, while also enhancing strength and stability.

This is a very promising company developing very sophisticated technology.

The Japanese domestic robot industry is set to grow to $22 billion by 2020.

This is a story I’ll come back to coming issues of Monkey Darts.