Editorial

Health IT “Taking the Pie”

Views: 4.6K

Innovation in Health IT seems to be the flavour of the season creating a niche in the healthcare industry

By Shally Makin

Health IT has now revamped the healthcare system providing strength of character to the healthcare infrastructure. IT is gradually picking up pace to integrate the economy from the forefront. Escalating demand for services and innovative solutions by the healthcare industry has pumped the IT sector to bring pioneering resolution to bridge the gap that lack of medical devices and software creates. According to a report by markets and markets in August 2011, the world healthcare IT market is expected to grow from US$ 99.6 billion in 2010 to US$ 162.2 billion in 2015, at a CAGR of 10.2 percent.

While US$ 4.5 trillion is spent on global healthcare annually, over 100 million people fall into poverty each year due to expenses incurred upon healthcare and approximately two billion people worldwide live without even basic healthcare. With greying populations, rising incidence of chronic diseases, and growing demand for tools tailored to local healthcare, markets healthcare lies in one of the world’s most pressing and complex problems. Companies like GE Healthcare, Philips, Draeger Medical, to name a few, have contributed a lot in the Health IT domain by introducing innovative products and technologies to provide effective treatment. Acquisition in the healthcare and life-sciences space for IT service providers seems to be quite proactive in the current market.

Today, technology is a key enabler for every industry. From imaging to tele-diagnosis, technology has proven useful in reaching the unreached masses as well. Health being the primary concern for an individual, needs to be closely looked at by providing affordable healthcare with the use of latest technology. Health IT client capabilities span a broad field of healthcare enterprise, including providers, hospitals/health networks, pharmaceuticals, medical devices, consultants, service and product vendors, healthcare organizations, legal, legislative and accrediting organizations and professional associations. Companies like Wipro-another IT major – are scouting for a niche player in the Health IT segment. The company also plans to hire about 200 more domain experts, especially those in the analytics and mobility space, by the year-end. Wipro will soon take up large-scale IT modernisation projects with the advent of the more comprehensive ICD 10 medical coding standards.

 Healthcare trends have changed from diagnosing patients in clinic to advising patients through the use of mHealth and telemedicine. Health IT has demonstrably come a long way since its inception. Electronic tools are becoming common in following five areas- treatment, exchanging clinical data with other physicians, notes on patient care, generating reminders, and writing prescriptions. With the use of tools such as EHR, EMR, e-Prescriptions and e-Reminders, exchange of clinical data has become much more efficient and streamlined. Information technology underpins providers’ ability to shift to new care models, so IT moves to center stage with efforts to implement products like hardware, software, networks, and radiology information systems, hospital applications, laboratory applications and ambulatory care management systems and other healthcare services. On the other hand, few healthcare providers already provide medical facilities including e-prescribing, PACS and online results reporting and scheduling along with telemedicine, HMIS, LIS and others. Health IT aims at improving the overall quality, safety and efficacy of the health delivery system which prevents medical errors, reduces healthcare costs and decreases paperwork.

Latest Market Trends

Toronto-based medical information service MedicAlert has developed a customized bracelet and necklace for use in medical emergency department. The gadgets also maintain the database of medical information. At the time of emergency the information is transferred to the effective treatment. MedicAlert has more than 4 million members worldwide and is available in 140 languages. Customers can access the medical records on their mobile phones as well. More than 40 percent of the company’s online traffic takes place after business hours.

Using such tools, physicians can edit their patient’s records and spend more time in viewing patients’ records to ensure there are no errors and update the patient for any risks.

A typical EHR has information about an individual’s health conditions, allergies, treatments, tests, and medications. Many EHRs can connect with health care providers outside the doctor’s office such as specialists, labs, imaging facilities (X-rays, CT Scans, MRIs), and the local hospital. Some EHRs have warning systems built in to let the doctor know about drug allergies or potential problems with drug interactions. Also, some EHRs have medical alerts to remind the doctor to perform certain tests or procedures.

Electronic prescribing or e-prescribing (eRx) is a way for the doctor and other health care providers to send the prescriptions to the pharmacy electronically. This reduces chances of error due to incorrect interpretation of a written prescription, and also helps in avoiding harmful drug interactions.

According to a recent survey published in the Business Wire, 75 percent of survey respondents claimed meaningful use of EMR is to be their top budget priority for 2011 IT investments, with 53.5 percent citing physician adoption of EMRs to be their greatest challenge in meeting that goal. 87 percent of respondents said time to access an EMR impacts physician satisfaction and 73 percent said that it also impacts overall patient care.

The survey found that adoption of Electronic Health Record System, which covers 8.7 million beneficiaries, eliminated 1,000 tons of paper records and 68 tons of x-ray film. Adoption of the system also lowered gasoline consumption among patients who otherwise would have made trips to the doctor by at least three million gallons per year. This shows that electronic health records have a positive net effect on the environment, and that our model for evaluating their impact can be used to determine whether their use can improve communities’ health.

Online portals are gradually picking up pace, and hold potential for promising growth in the next five years, particularly in the areas of telephone counseling, self-help and web-based support services. Adoption of online services can help overcome distance, as well as financial and attitudinal barriers faced by the developing countries. For example, the I-med network developed by Queensland software helps doctors to log in and see the patient’s radiology images regardless of where they happen to be.

Remote-I, an initiative of CSIRO health scientists uses broadband network to treat eye disease in the remote Pilbara region of Western Australia. It uses static imagery, store-and-forward, and video conferencing (although not all at once) to take high-resolution images – some of them in 3D – of the retina and then sends them to specialists in urban centres for analysis. The information is then transferred to the computer for analysis. After this, treatment guidelines are transmitted back to clinic staff at the remote location. The system uses static imagery for low-bandwidth situations and, video conferencing imagery for high bandwidth use. It is based around the HL7 industry standard, ensuring interoperability with a wide range of hardware and software solutions.

Over the years, tele-health has linked physicians to each other, fostering better collaboration and problem-solving, rather than linking patients to the physicians. When reimbursement for telemedicine services is slow, the effort to gain physician’s role may be better served by focusing on the improvement in clinical outcomes through access to resources. There are patient rooms dedicated to create a virtual “exam room” linking real-time audio and video communications with mobile devices.

P&G Future Works, the MNC’s entrepreneurial engine recently funded Healthpoint Services – a startup that runs rural clinics to provide affordable primary healthcare in developing countries. It provides rural communities with access to four basic services: clean drinking water, access to qualified doctors via telemedicine supported by two-way video and electronic medical records; advanced on-site diagnostic capability, enabling evidence-based healthcare; and high-quality medicines via an onsite licensed pharmacy. Healthpoint offers 22,000 medical consultations and serves over 50,000 people daily with drinking water. This may help in overcoming infrastructural challenges at the PHCs level in the developing countries.

As hospitals automate their manual, paper-based processes, IT leaders are rethinking their server and desktop infrastructure strategies. The consumerisation of IT has CIOs scrambling to deal with demands for iPads, iPhones and other personal devices brought into the hospital by a technology-comfortable physician.

The industry has shown an unprecedented response from the Health IT providers to the existing users that were apparently resisting the change from paper to electronic, who now want to entirely convert everything on the latest and smart devices. Medical imaging has certainly been a driving case in improvements of graphics rendering for the virtualization vendors. USB device support has improved, with a number of successful deployments that justify desktop virtualization as a viable solution.

The benefits of PACS are many, including the ability to view imagesfrom multiple locations, accessibility to reports, collaborative diagnosis, quicker image delivery and reducing the incidence of lost films with advanced 3D post processing and easy-to-use technology. The Secure Reporting Sytem (SRS) provides a secure electronic “mailbox” for physicians to automatically receive medical transcription, lab results and other pertinent patient related reports. Access is restricted to the physician and their chosen delegates and the reports are only for those patients where the provider is listed on the case.

Challenges

With increasing integration of IT in healthcare, privacy and security issues are acquiring more significance. A few companies have installed firewall and intrusion detection software to protect the information. Since all health plans are now drifting towards transforming all information into electronic format, the risk of unauthorised access to medical records increases as records would be available to the patient, doctors as well as to all the healthcare providers.

Over the past several years there have been a number of instances of security breaches in hospitals and doctors’ offices resulting in medical identify theft. Access to personal information may allow thieves to bill for medical services in the patient’s name.

The challenge to the health IT fraternity is to create the next-generation telemedicine system that can provide a true multi-point communication platform, allowing everyone involved in the medical case to securely view the same data and medical records at the same time regardless of the communication device used. With the advent of cloud-based technologies, services and software applications, a dedicated enterprise network in a single location should be developed, enabling better medical collaboration and information sharing via secure real-time audio, video, and data links.

Using clinical IT systems as the engine for quality improvement is a logical endeavour. Until about a decade ago, IT systems were intended to automate transactions in hospital departments. When the business became more enterprise-focused, the emphasis shifted to improving processes across departments. IT departments today may have accomplished a lot of good, but the traditional processes did not allow the department to get data capture in a way that can be aggregated and use it to really drive improvements in quality. With the advent of rampant research and development in the IT sector, many hospitals are buying practices, or looking for innovative ways to provide services that allow practices to improve patient care by applying the latest technologies, without having to worry about implementation and management.

96 Comments

96 Comments

  1. Along these lines site which means that because the country’s as a result fine. It has the quite rare that an intruder carries an extremely beneficial home page as if you. offer would you replace that home-page and also your web blog? Appearances ideal. have a nice great morning. l8rs sally

  2. I think the red is bold amd cute. The bright blue jeans are nice too, and not as 'out there' as the hot pink….although, we do love hot pink! I would go for red.

  3. cheap car insurance Englewood CO

    April 13, 2018 at 1:44 pm

    estou tentando engravidar, uma semana antes do meu atraso mestrual que e pra vir dia 24 de novembro fiz um exame de sangue beta hcg e o resultado foi 0,88 eu nao entendi o que isso significa estou confusa e muito ansiosa, por favor me responda nao entendi a tabela acima e fiquei sem graça de perguntar no laboratorio!!!! desde ja agradeço…

  4. affordable car insurance Acworth GA

    April 13, 2018 at 3:05 pm

    J’aimerais beaucoup participer à ce genre de séance prêt de chez moi… Si quelqu’un est motivé pour monter le projet, je serais la première cliente. Mais seulement dans le 92 ;o)

  5. Steve Wentz December 3, 2012 A great start to the day… especially a Monday! I appreciate your comments and for addressing this subject in a way I’ve never seen done before. Very effective.

  6. cheapest car insurance South Bend IN

    April 13, 2018 at 8:13 pm

    Tu parles de l’IRC comme d’une panacée, mais je tiens a signaler que sur IRC il n’y a à ma connaissance aucun controle effectué pour ce genre de chose.Facebook et Twitter surveillent leur contenus pour y retirer la pédopornographie, et repondent aux demandes des gouvernements, mais sur IRC il n’y aucune régulation. Ce qui est dit sur IRC reste a postérité. La « liberté » d’expression sur IRC est encore plus « americaine » si l’on peut l’appeler ainsi…

  7. car insurance rates Riverside CA

    April 13, 2018 at 9:09 pm

    It’s true, therapy isn’t for everyone. And it is true that there can be bad therapists out there (I always shudder when I hear someone tell about a bad experience). I always wish that psychotherapy will be meaningful and helpful to any who enter into it.

  8. full coverage car insurance Sevierville TN

    April 13, 2018 at 10:41 pm

    bè…sicuramente hanno fatto i loro studi e quindi probabilmente, come dici tu avranno tentato di fare un certo tipo di operazione e sperare in un effetto virale guidato dagli ormoni … fatemi sapere se avete news a riguardo (risultati, ecc…)Ciao!

  9. list of car insurances in Ypsilanti MI

    April 14, 2018 at 1:05 am

    I’m also commenting to let you be aware of what a nice experience our girl obtained reading through your web site. She came to understand several details, including what it is like to have a wonderful giving mindset to let other people without difficulty grasp specific advanced subject areas. You actually did more than people’s expected results. I appreciate you for imparting such informative, dependable, educational not to mention fun guidance on this topic to Emily.

  10. Wow, fantastic website layout! How extended have you been blogging for? you make blogging search quick. The total search of one’s net internet site is magnificent, allow alone the content material!. Thanks To your post about Adobe Just after Effects FireString Intro | Tutorial Vids .

  11. auto insurance Barnesville GA

    April 14, 2018 at 1:40 am

    I am a huge Oscar Wilde fan. While doing some research on Wilde and the Victorians, I stumbled upon the fact that “earnest” was a word commonly associated with gay men. Some people believe “The Importance of Being Earnest” hints at this, as Wilde was a homosexual himself. Based on this knowledge, the famous Bristol Old Vic Theatre performed “The Importance of Being Earnest” with an all-male cast. Unfortunately, they can never re-use the costumes from the production, as all the female dresses were made for large men!- Gary Webber

  12. direct auto insurance Sherman TX

    April 14, 2018 at 1:50 am

    Focused on Teamwork, New Tax Holiday November 28, 2012 Nic Horton Leave a Comment Part Two of our Advancing Arkansas series is an interview with Rep. Andrea Lea

  13. car insurance rates Kent WA

    April 14, 2018 at 3:56 am

    Impossible de poster un commentaire aprés l’élection incroyable de Barack OBAMA.Un grand merci au peuple américain pour avoir osé le changement et nous redonner espoir pour un avenir meilleur!YES WE CAN ne l’oublions pas!Soyons positifs et optimistes, solidaires et exemplaires, Barack Obama nous a ouvert la voie, soyons prêts à le suivre, nous en sommes capables, tout est question de volonté.YES WE CAN!!!

  14. cheapest auto insurance Norwalk OH

    April 14, 2018 at 6:48 am

    I like the best way you wrote this informative article. This is great. I do hope you intend to produce additional of such kinds of articles or blog posts. Thank you for this intriguing articles!

  15. full coverage car insurance Schenectady NY

    April 14, 2018 at 9:05 am

    While responding to a website contact us button, the computer (not my usual Mac) made me use an unfamiliar email format and when I finished sending and went back to Yahoo, everything in my inbox had been deleted and wasn’t in trash.

  16. free car insurance quotes Helena MT

    April 14, 2018 at 11:03 am

    This article is excellent and you have done a great job getting your point across in this content. I’m impressed with how well you have stated your points of interest with such interesting, original thinking.

  17. list of auto insurances in Blacksburg VA

    April 14, 2018 at 1:10 pm

    Ah oui excellente information sans l’ENSAE beaucoup d’élèves de Dauphine ne pourraient pas rendre des mémoires de qualité… Vu le nombre de mémoires sous-traités…

  18. auto insurance quotes Binghamton NY

    April 14, 2018 at 8:34 pm

    Phillip, Thank you for your self disclosure and courage. There isn't much for me to add to the eloquent comments above. I wear hats every day, and some people are uncomfortable with my self expression. I have decided that it 'weeds out' people that I don't want to spend time with anyway. However, I realize that it's easier to have this attitude in an urban area than in a small community. Thank you for bringing this issue to Advanced Style, and thank you Ari for addressing and naming this abuse.

  19. Write your Congressman and tell them to STOP the H1B Visa program. Millions of Americans out of work and we are still importing cheap labor. Shameful!

  20. non owners auto insurance quotes Taylors SC

    April 14, 2018 at 10:14 pm

    This is great informative content that obviously has a lot of thought and work rolled into it. I can tell you are an intelligent person by the way you express your unique and original views.

  21. payless auto insurance Willis MI

    April 14, 2018 at 11:35 pm

    Cesar, tu problema es bastante sencillo en verdad.Dependiendo de la dirección por la que ingresas al servidor es la que usara para buscar las imagenes y estilos.Si sigues el tutorial y defines lo siguiente:define(‘SERVER_NAME_PUBLICO’, ’200.52.219.209′);define(‘SERVER_NAME_PRIVADO’, ’192.168.1.8′)Y usas los case del switch para definir WP_SITEURL y WP_HOME no deberías tener ningún problema.Que estés bien Cesar y que te sirva !

  22. low income auto insurance Florence KY

    April 15, 2018 at 1:29 am

    Peggy Holloway, an analyst at Moody’s Investors Service.“From a liquidity perspective, they are on the brink of bankruptcy,” New York-based Holloway said in an interview. “It depends on their ability to negotiate with lenders and willingness to amend the debt.”

  23. payless auto insurance Charlotte NC

    April 15, 2018 at 1:47 am

    Jehi,Some of us just read and enjoy without necessarily commenting, but I do agree that more people should get to read Sultan's extremely thought provoking writing. Well worth it for even those coming from a different direction. I read it often, but don't always have much to add, so when I do comment it's usually just to thank Mr. Greenfield. There's really no one quite like him.

  24. full coverage auto insurance San Diego CA

    April 15, 2018 at 3:30 am

    I’m seriously flower challenged too and I’ve got a gazillion so I don’t have an excuse…but can I say your card is gorgeous and you’re thinking far too much lol!!!!

  25. car insurance quotes Portland OR

    April 15, 2018 at 4:02 am

    Jessica Rabbit is way too voluptuous, Betty is obviously an idiot if she stays with Barney, and Cheetara is just a bit too dangerous. She-Ra might be okay.

  26. cheapest car insurance in Sevierville TN

    April 15, 2018 at 6:51 am

    schööööne bilder…..schneee… wir hatten hier ja auch schnee vor zwei wochen…für Irland echt viel schnee..ich hab die landschaft genossen und mich heimisch wie noch nie gefühlt..aber das autofahren ohne winterreifen war nicht so spassig.Ich hoff du überstehst die fasnacht gut und triffst nicht zuviele schnappsleichen an.. ;o)schmmatzer aus Irland

  27. free car insurance quotes South Gate CA

    April 15, 2018 at 1:50 pm

    na chemotherapie? Dat is een onmogelijkheid.Het zou kunnen zijn dat het lichaam zichzelf geneest van de kanker (zie de inzichten vanuit German New Medicine), ONDANKS dat het lichaam chemo te verwerken heeft gekregen. Het kan dus zijn dat het zelfgenezend vermogen van de persoon geactiveerd is VANUIT de persoon zelf. Maak je geen illusies: allopathische middelen genezen nooit.

  28. auto owners insurance Wichita KS

    April 15, 2018 at 2:36 pm

    A cada ano a FECORS vem se destacando pelo empenho em oferecer diferentes estímulos, à formação e aperfeiçoamento de recursos humanos que se interessam em divulgar o Canto Coral. Parabéns pelo trabalho desenvolvido! Olinda Trindade

  29. here's a thought, how about showing the shoe being worn on an actual foot instead of floating in the fantasy limbo world of white space they're pretty and all, but it's hard to tell how realistic they are.

  30. tempo, but are not the only author…contributing content.you can do this quite simply by setting up a cms that allows others to chime in, share their opinion, offer advice, articles and perspectives, and even their own profiles, user names, pictures and otherwise. the best part is that…

  31. low income car insurance dmv Haledon NJ

    April 15, 2018 at 5:18 pm

    Nå Agnete og Rikke, det er lettene athøre når man trode at man skulle undvære Shakerzone.dk i tre uger :)God ferie Emma.Mvh zeleste

  32. cheap auto insurance Jackson MI

    April 15, 2018 at 6:25 pm

    son cinco años contando que lo hacia en tiempo libre, y con esa habilidad sin iugar a dudas el tipo debe tener un trabajo en el que el tiempo libre debe ser muy minimo

  33. best car insurance in Wooster OH

    April 16, 2018 at 6:13 pm

    Ich freu mich immer extrem wenn du wieder ein neues Video gemacht hast Ich würde gerne gewinnen, da meine derzeitige Tastatur nicht mal nen Standby Knopf hat..

  34. best car insurance in San Bernardino CA

    April 16, 2018 at 6:36 pm

    jgn asyik tnding jri pd driver je,kite xthu keadaan yg sbnar sape yg slah..neh sume rahsia allah swt.kite yg idop truskan,pd kuarga yg t’libat takziah sesame lar kite b’doa smoga roh2 mrk dtptkan org22 yg b’iman..al-fatiha…………….amin

  35. cheapest car insurance Perth Amboy NJ

    April 16, 2018 at 9:34 pm

    This is the straight Blog – alternativna medicina | Balans Medika Beograd – O zdravlju, lepoti journal for anyone who wants to seek out out near this subject. You attending so often its virtually wearing to represent with you (not that I really would want…HaHa). You definitely put a new whirl on a matter thats been typewritten nearly for age. Prissy nonsensicality, simply uppercase!

  36. car insurance rates Catonsville MD

    April 16, 2018 at 10:48 pm

    voy a leer la sociedad de control de versus… porque así saco tramas para escribir ficción, aunque Iker Jimenez es una fuente inagotable pero está bien saber que en realidad el más allá está en el más acá tan bien (si mi inspira algún relato ya os cuento |

  37. best car insurance in Elizabeth NJ

    April 16, 2018 at 11:38 pm

    Wall display cases can also be made with a top in glass. This way one can take full advantage of the natural light and on top of that it does accentuate the clear look of your display showcase. In this case I would strongly recommend building your display showcase with a thin base cabinet.Adding side track lighting on each of the sides of your display case will reinforce also the modern look or contemporary look of the display case.This is a good alternative to tall and heavy cabinet wall showcases.

  38. tenho a assinatura da revista gloss e atraves dela passei a conhecer a lezalez.com/resultado entrei no site e me apaixonei por tudo.beijos pra vcs do grupo lezalez.patricia vieitez /pernambuco

  39. free auto insurance quotes Annapolis MD

    April 17, 2018 at 12:28 am

    I will assume that you do not know what you are talking about in regards to his parking since you qualified it by saying I may be wrong.As for our research on this story or any story, we do not reveal our sources, just as the News-Sentinel, WVLT or any legitimate media will not reveal their sources. Thanks for asking, you never know until you ask and Thanks for reading, Brian’s Blog.

  40. payless auto insurance Mount Juliet TN

    April 17, 2018 at 1:09 am

    According to the Canadian Nuclear FAQ we seem to do a lot better overseas than at home on nuclear projects 1996 Cernavoda-1 Romania On budget, on schedule1997 Wolsong-2 South Korea On budget, on schedule1998 Wolsong-3 South Korea On budget, on schedule1999 Wolsong-4 South Korea On budget, on schedule2002 Qinshan-4 China On budget, 6 weeks ahead of schedule2003 Qinshan-5 China On budget, 4 months ahead of schedule2007 Cernavoda-2 Romania On budget, on scheduleEndless delays have hampered the Bruce Project as they did the Darlington mostly do to regulatory interference, apparently when these are minimized these builds can be done on time and on budget.

  41. cheapest auto insurance Sylmar CA

    April 17, 2018 at 5:27 am

    Oi, Ana!Já votei lá em vc, viu?Tem vários selinhos ali no meu blog… Vi que vc gosta de recebe-los, então passe lá e pegue todinhossss!!!! eheheheeheheh Depois eu venho aqui te visitar de novo pra ver as suas respostinhas…Beijinhossssss

  42. low income car insurance Florissant MO

    April 17, 2018 at 5:55 am

    I’m building a custom PC, and I want to know how the i7 2600K Sandy Bridge 3.4GHz(-3.8GHz Turbo) compares to this as a reference.I am a moderate gamer, a student, and I type a lot. would this be good enough?

  43. low income auto insurance dmv Jonesboro GA

    April 17, 2018 at 6:00 am

    It's good to know that agents aren't always looking for the "trend." I understand you want to make money (so do we) but "the next great thing" is just around the corner and you can't find it by always buying a mimic of the current great thing.(and, Patrick, Zombies rock. 🙂 )

  44. auto insurance quotes Birmingham AL

    April 17, 2018 at 9:22 am

    I think that buying the mall was a good idea. Leaving it in the hands of the out of town private owners that didn’t care that it was deteriorating was hurting us. We had no control of what it was turning into as long as it was in the hands of the Gatto family.

  45. gli ultimo libri comprati al mostriciattolo sono:il paese delle pulcette e la favola dei caldomorbidi.non sono proprio per un piccolo di 21 mesi, ma li ho presi "in crescenza"…poi si prestano a lavoretti vari (es. costruire la propria pulcetta e avere un sacchetto pieno di caldomorbidi)però i tuoi li ho messi TUTTi nella wishlist di amazon (anche se alcuni non li hanno)frank

  46. list of auto insurances in Lake Forest CA

    April 17, 2018 at 10:15 am

    kanske tog jag för mycket kanel, 1 mskrÃ¥gad till 3 smÃ¥ ägg lite grädde… tyckte inte speciellt mycket om den… kanske stekte jag för länge???vet ej vad som blev fel…

  47. Bravo! Esti de-al meu. Si eu le urasc. Cand am fost prin a 3-a am aruncat doua pisici de-ale lui bunica in fantana. Am si scris un post despre asta. :)) .-= Ultimul articol al lui Marian – Twitter, Hi5 ÅŸi Gravatar. Åžmecherii (ÅŸi mai ziceÅ£i că nu sunt hecăr) =-.ÃŽÅ£i place? 0

  48. Umno bersekedudukan dengan Mic, Mca, Gerakan dan yg sewaktu denganya.Dap yg nak berkawan dengan Pkr dan Pas.Umno cakap nak mertahanankan kedudukan islam, tapi ha..ha..ha..lesen judi lulus lagi, hukum hudud tolak, mempertahankan apa yang umnocakap, macam mu*******k bunyi nye

  49. Great work guys!I have installed one SSD and one HDD with your kit. Boot volume is the SSD and all programs are on the SSD. Will a switch to FusionDrive bring any performance upgrades?

  50. low income auto insurance Brandon MS

    April 17, 2018 at 3:17 pm

    Jaaa Ulrika – och det behövs inte ens speciellt lÃ¥nga procedurer, nÃ¥gra medvetna djupa andetag räcker lÃ¥ngt. Sen kan man kramas

  51. cheapest car insurance Lutz FL

    April 17, 2018 at 3:53 pm

    Congratulations for posting such a useful blog. Your blog isn’t only informative but also extremely artistic too. There usually are extremely couple of individuals who can write not so easy articles that creatively. Keep up the good writing !!

  52. car insurance rates Wentzville MO

    April 18, 2018 at 12:34 am

    Hmm it appears like your site ate my first comment (it was extremely long) so I guess I’ll just sum it up what I had written and say, I’m thoroughly enjoying your blog. I as well am an aspiring blog blogger but I’m still new to everything. Do you have any suggestions for inexperienced blog writers? I’d genuinely appreciate it.

  53. auto insurance quotes Florissant MO

    April 18, 2018 at 3:15 am

    gearge bush was not a disappointment, no one sane expected anything good from him.i didnt say no one was worse. but people had great hopes about Obama.

  54. Baufinanzierung berechnen

    April 18, 2018 at 3:48 am

    Hi there! Solve you identify proviso they make some plugins to help with Explore Engine Optimization? I’m wearisome to get my blog to rank in support of approximately targeted keywords but I’m not since fantastically nice results. Condition you get of any entertain distribute. Thanks!

  55. cheap sr22 insurance Midland TX

    April 18, 2018 at 5:01 am

    Ah c’est drôle, j’en suis là aussi avec ma Supermiss ! Il a fallu la mesurer 5 ou 6 fois au mois d’août et ne pas rire devant son air contrarié puisque nous étions “à égalité”. Mais depuis, tous les deux jours, elle s’écrie ” ça y est ! cette fois -ci je suis plus grande !” Et moi, je suis toute attendrie.

  56. car insurance quotes IL

    April 18, 2018 at 8:45 am

    Great – I should definitely pronounce, impressed with your website. I had no trouble navigating through all tabs and related information ended up being truly easy to do to access. I recently found what I hoped for before you know it at all. Quite unusual. Is likely to appreciate it for those who add forums or anything, site theme . a tones way for your customer to communicate. Nice task.

  57. cheap auto insurance quotes Bolingbrook IL

    April 18, 2018 at 10:39 am

    georgina chapman co-founds marchesa As a result of their dress-making sessions, Georgina Chapman and Keren Craig inherited a valuable ally. Former magazine editor and style expert extraordinaire Isabella Blow noticed their designs and encouraged them to branch out on their own. Now finished with school, the two aspiring fashion divas co-founded the Marchesa label in 2004, named after Marchesa Luisa Casati, a scandalous socialite of the early 20th century..

  58. auto insurance Corona CA

    April 18, 2018 at 4:01 pm

    "guess it's all part of being black and old?"Well that makes her two for two in my book. "move.org had 2 ads on it website comparing Bush to Hilter."Again, links please.

  59. payless auto insurance Upland CA

    April 18, 2018 at 6:07 pm

    i got 2 hand it 2 u … i got 2 hand it 2 u iv seen sum people try 2 do they songs and sum have succeeded but they would b like 1 min off or 3 sec off and it just would not soung right but this is cool the sound is loud and vibrant really gud cant wait 2 download it XD

  60. cheapest car insurance Boston MA

    April 19, 2018 at 12:05 am

    Jee, kissakirjakokoelma!! Mie katsoin tätä kirjaa kirjastosta, mutta ajattelin että onko se liian ahdistava tuon kissan sokeuden tähden. Ehkä mie sitten kuitenkin uskallan lainata tämän, koska yleensä ollaan tykätty samoista kirjoista.

  61. Hi Lo!!!! thnk alot for this post. i’ve alwys do some exercise at home i don’t eat much coz i’m afraid to gain some weight and i want to have nice body too… i lost weight i’ve become smaller but i dont have the curve… now i know why my body doesn’t improve coz i don’t eat much… i want to start again as a begginer and to get the kind of body that i want.. thnku so much now i know how get wider hips!!!!

  62. no down payment car insurance in ND

    April 19, 2018 at 4:56 am

    C’était voulu… Mais il affirme que tlm a droit de s’exprimer et que si on est pas content qu’on a juste a aller voir ailleur.Je dit qu’il a l’air cave sur sa photo pas qu’il est cave. Et je pense pas que personne ici va me dire qu’il a une photo qui a du bon sang. Sinon vous retournerai lire le dernier article avec les commentaires qui vont avec.

  63. cheap sr22 insurance Redondo Beach CA

    April 19, 2018 at 5:07 am

    Great Blog. Internet selling offers the little benefits to marketers compared to normal approaches. The categorical good of the online selling is to put together opposite aspects of any selling debate.

  64. car insurance in Belleville MI

    April 19, 2018 at 6:02 am

    The stew looks yummy. I certainly never saw lentils as a kid. My favorite dish growing up would be spaghetti with meatballs. I lived in an Italian neighborhood and I loved getting invited to my friends’ houses for dinner. Yum.

  65. payless auto insurance Davenport FL

    April 19, 2018 at 6:32 am

    Thank you for another informative web site. The place else may just I am getting that kind of information written in such an ideal method? I’ve a venture that I am simply now running on, and I’ve been at the glance out for such info.

  66. average car insurance rates in Coventry RI

    April 19, 2018 at 6:49 am

    I wish I had signed up for that FitFluential test drive of their goods! I kinda thought they were too young for my age but maybe not.. Great post & review!Jody – Fit at 54 recently posted..

  67. Yet despite the centuries long contact with Mongols and other Asians, there are more "absolute" blonds in Russia than anywhere else in the world, including Scandinavia and the Balkans.

  68. car insurance rates Gonzales LA

    April 19, 2018 at 7:35 am

    absolut Ellja – du solltest mal in meine Wohnung kommen – eine Schatzkammer – ich bin da wählerisch da ist alles dabei von ultra modern bis total retro oder antik…. Ich finde diese Schätze überall – besonders gerne auf Reisen – das kann Bekleidung sein oder Wohnaccessiores – viele Dinge spüre ich auf Flohmärkten auf.

  69. car insurance rates Garden City NY

    April 19, 2018 at 8:28 am

    Do youve a spam problem on this internet site; I also am a blogger, and I was wondering your scenario; we have developed some good approaches and were looking to exchange options with other individuals, be positive to shoot me an e-mail if interested.

  70. non owners car insurance quotes AR

    April 19, 2018 at 1:37 pm

    Five months ago, Arianna Huffington (and, one presumes, her bags of money) lured Maura Egan away from The New York Times. Now, as WWD Egan is leaving her gig as deputy culture, and lifestyle editor of the Huffington Post/AOL behemoth. She doesn’t have any immediate plans, other than going to the beach. There are two ways to look […]

  71. list of auto insurances in Yorba Linda CA

    April 19, 2018 at 1:44 pm

    Acho tão legal chegar de bike num lugar onde ela não é bem-vinda. As discussões sempre pautadas por argumentos sem fundamentos, ou sem qualquer argumento mesmo. Não dá pra simplesmente ignorar, concordo que tem que bater o pé pelo menos uma vez. Chega um, chegam dois, chegam dez, chegam cem. A cara de bobo que eles ficam é a melhor!

  72. look auto insurance Parkersburg WV

    April 19, 2018 at 3:00 pm

    N’empêche….Admettons, pour la discussion, que le problème, c’est qu’on est trop « difficile » (pour ce que ça veut dire).On fait quoi alors? On couche/se met en couple avec quelqu’un alors QU’ON EN A PAS ENVIE? Me semble que c’est pas le but recherché….« La bandaison, papa, ça ne se commande pas. »(Brassens)*on jase*

  73. car insurance Spring Valley NY

    April 19, 2018 at 5:34 pm

    Pat (79)-Is smuggling a homemade nuclear device into the US and detonating it one of the choices?“If you were an investor, let’s say from somewhere in the Middle East, what project would you be most likely to participate in: a giant widget factory in Indiana, or the backbone of a new international health care management system that included pre-translated patient records and low-cost country sourcing?”

  74. best auto insurance in Louisville CO

    April 19, 2018 at 6:13 pm

    couple of tweets on the subject:“Darrell Issa is as angry at #fastandfurious as he was silent when the Bush administration started it.”“Fast and Furious proves it’s treason to sell weapons to bad guys. Unless it’s Iran & you’re Reagan. That’s awesome.”“Obamacare was 2700 pages and that’s too much to read; Holder turns in 7600 pages and its not enough”

  75. us agency car insurance Kent OH

    April 19, 2018 at 8:55 pm

    I think this is one of the most important info for me. And i’m glad reading your article. But want to remark on some general things, The website style is great, the articles is really nice : D. Good job, cheersVA:F [1.6.5_908]please wait…VA:F [1.6.5_908](from 0 votes)

  76. best car insurance in Elizabethtown KY

    April 19, 2018 at 9:36 pm

    I am a product of the 1950s and ’60s when many African Americans struggled and died to secure the right to vote for the descendants of slaves who had been disenfranchised by the political process. I keep this imagery with me each time I vote in any election. I find it extremely disturbing when people, particularly young blacks and other minorities, fail to exercise this most precious right of citizenship. The onus is on those of us who understand the importance of voting to use every forum and opportunity to demonstrate its importance..

  77. cheap non owners insurance in Holland MI

    April 20, 2018 at 4:47 am

    « Mylène essaie de ressembler à Lady Gaga » Mais biensûr, et la marmotte…Mylène n’a pas attendu Lady gaga ! Puis red one n’a pas bossé qu’avec lady gaga, on a jamais dit que enrique iglésias faisait du gaga, pourtant c’est red one. Aaaaaaaaah ça m’énerve !!  jeni

  78. best auto insurance in La Habra CA

    April 20, 2018 at 1:55 pm

    I simply wanted to make a quick message in order to appreciate you for the great steps you are giving at this site. My extensive internet search has at the end of the day been paid with pleasant points to go over with my family members. I ‘d say that we website visitors are definitely lucky to be in a really good website with many perfect individuals with insightful strategies. I feel very much privileged to have come across the web pages and look forward to tons of more awesome times reading here. Thanks once more for a lot of things.

  79. cheap car insurance Brookfield WI

    April 20, 2018 at 2:51 pm

    If I were them, I would hide in the closet. Because you can hide among the clothes and it is not easy to be found.When I encounter the difficulties or frustrations, I will stay in my room to calm down. Because I can do anything what I want to do in my room. For example, I can play the computer games, listen to the music or take a nap. In my room, I can release my pressure and then I will feel better. My room is very important for me.

  80. cheapest auto insurance in NJ

    April 20, 2018 at 2:59 pm

    preciso de um terreno ou predio na marginal a venda , o predio tem que ter 6 andares , se for terreno preferimos com o plano de massa o preço que o propietario esteija a vender.meu numero 925483278 meu email ……urgencialocalizaçao em angola na Marginal cidade de luanda, pode ser na traseira ou afrente.

  81. privatkredit vergleich

    April 20, 2018 at 4:17 pm

    Great – I should definitely say I’m impressed with your site. I had no trouble navigating through all tabs as well as related information. It ended up being truly simple to access. Good job..

  82. best car insurance in Hamilton OH

    April 20, 2018 at 5:22 pm

    HEKKAN sååååå flott den ble!!! Eg laget mye trolldeig før og elsket det! Kanskje det hadde vært noe formeg nÃ¥ som eg skal sitte her med brukket tÃ¥/vrist i noen uker hmmmmmm det hadde vært kjekt ja!!! Kooos deg og ha en herlig lørdag! klem vibbedille 🙂

  83. affordable car insurance Pleasant Grove UT

    April 20, 2018 at 5:52 pm

    Yes thanks Qix, on looking at it again with your explaination that really does make sense sometimes I am so glad to get the answer that I can’t ‘see’ any further and on other occasions I just look for too much in a clue, if that makes sense?

  84. free car insurance quotes Starkville MS

    April 20, 2018 at 8:45 pm

    Thanks for replying. That’s what I was planning to do: check out my local library and a local used books store. Will let you know if have any success.xxmayaSoccer Mom Style recently posted..

  85. auto insurance Branson MO

    April 20, 2018 at 9:43 pm

    Thanks for your heroic dawn driving – and for letting us know about the day.Some useful points here. The requirements of that "new curriculum" sound very worrying while the session about objects sounds an inspiring pleasure. Oh dear. I had forgotten about that "Arts" preference for residencies rather than the one-day author visit. One day is often all some schools can afford.Let alone the matter of where it's useful for writers to live to get such work.Your own in-school sessions sounded just what was wanted.

  86. list of car insurances in Hamilton OH

    April 20, 2018 at 10:19 pm

    I remember reading that the south of the Pyrenee basques are a recent population, that in roman time they lived mostly in what is now Aquitaine. The names of the tribes that populated what is now Euskadi and Navarre as reported by romans seem either celtics or other pre-IE.

  87. dit :Alors j’ai eu ma rentrée “administrative” aujourd’hui : inscription à la sécurité sociale, et récupération de l’emploi du temps.En lisant ton article je me suis dit que je n’avais toujours pas vidé mon trieur de l’année dernière que je compte recycler, qu’il faut que je range les cours qui sont à l’intérieur du trieur.Je reprend jeudi, j’ai mon rapport de stage à finir.Donc la rentrée préparée oui je valide j’ai acheté ce qu’il me fallait, par contre rangée pas du tout !

  88. free car insurance quotes Duncanville TX

    April 20, 2018 at 11:56 pm

    Hi Randy, Greetings from Jamaica. Thank you very much! The words of this song are so uplifting. I will definitely mention it in a blog post in the near future. Take care and have a good weekend. Judy

  89. cheap non owners insurance in Longwood FL

    April 21, 2018 at 1:37 am

    Wow, superb blog layout! How long have you been blogging for? you make blogging look easy. The overall look of your site is great, let alone the content!. Thanks For Your article about Television WILL screen pro-abortion adverts amid storm of controversy | The LifeLeague .

  90. auto insurance Royal Oak MI

    April 21, 2018 at 3:10 am

    Hey Douglas,I was thinking – now that ‘you’ mentioned it -maybe, we could get King Abdullahto ring upMcGuinty aka ‘Peter Pan’ – big boy in pyjama’s –and tell him to go to his room –the party’s over!Let’s make plans!p.s. yes, Assad is brutal

  91. · This is such a beautiful post. The last sentence is wonderful, and has given me much food for thought. The unknown is always what we get hung up on, driving us to fear or faith. I’m working on finding peace with the latter.

  92. low income auto insurance dmv Erlanger KY

    April 21, 2018 at 6:17 am

    Skjønner ikke hvordan man kan rote slik med begrepene; “Liberal – ikke liberalistisk” For meg lyder dette manipulerende. Sjekk BokmÃ¥lsordboka og Wikipedia, sÃ¥ ser du at en liberal er en som er tilhenger av liberalisme. -Liberalisme er en ideologi.

  93. cheap car insurance Louisville KY

    April 21, 2018 at 6:47 am

    Fantastic beat ! I wish to apprentice even as you amend your website, how can i subscribe for a weblog site? The account helped me a applicable deal. I were a little bit acquainted of this your broadcast provided brilliant transparent idea

  94. full coverage car insurance Duluth GA

    April 21, 2018 at 10:08 am

    Prosím o informaci,zda je možné si vzít půjču na mého syna pro nákup léků…je nesvéprávný,já jsem stanoven soudem jako opatrovník.Jemu 20 let.autista..Držitel ZTP-P..Důchod má 9.143 kč.Já jsem v žádné bance neuspÄ›l a sán si vzít na sebe nemohu,jelikož pobírám 8.000 kč jsko pečující osoba-POB..DÄ›kiji za odpovÄ›d..

  95. car insurance in Marysville OH

    April 21, 2018 at 10:38 am

    Like Libellule I also struggled with this one and didn’t find it particularly enjoyable which is unusual for a Rufus.I’d never heard of a jolly being slang for a sailor or marine before,Favourite clue 17. I always like clues where a sequence of letters in English can be pronounced in a totally different way which adds to the misdirection,

  96. car insurance Humble TX

    April 21, 2018 at 12:15 pm

    I’m impressed, I penury to articulate. Actually not a lot solve I come across a weblog that’s each educative and entertaining, and allow me notify you, you have got attain the nail by the head. Your thought is outstanding; the difficulty is something that not an adequate amount of persons are speaking shrewdly in relation to. I am very happy that I stumbled throughout this in my obtain representing impressive regarding this.

Leave a Reply

Your email address will not be published.

Most Popular

 

 


 

 

Get Heard Portal

 

eHealth Event Report

 

 

To Top