Anders Grimsmo | Norwegian University of Science and Technology (original) (raw)
Papers by Anders Grimsmo
International journal of integrated care
To identify barriers to deployment of four articulated Integrated Care Services supported by Info... more To identify barriers to deployment of four articulated Integrated Care Services supported by Information Technologies in three European sites. The four services covered the entire spectrum of severity of illness. The project targeted chronic patients with obstructive pulmonary disease, cardiac failure and/or type II diabetes mellitus. One health care sector in Spain (Barcelona) (n = 11.382); six municipalities in Norway (Trondheim) (n = 450); and one hospital in Greece (Athens) (n = 388). The four services were: (i) Home-based long-term maintenance of rehabilitation effects (n = 337); (ii) Enhanced Care for frail patients, n = 1340); (iii) Home Hospitalization and Early Discharge (n = 2404); and Support for remote diagnosis (forced spirometry testing) in primary care (Support) (n = 8139). Both randomized controlled trials and pragmatic study designs were combined. Two technological approaches were compared. The Model for Assessment of Telemedicine applications was adopted. The proje...
BMC health services research, 2015
In Central Norway a generic care pathway was developed in collaboration between general hospitals... more In Central Norway a generic care pathway was developed in collaboration between general hospitals and primary care with the intention of implementing it into everyday practice. The care pathway targeted elderly patients who were in need of home care services after discharge from hospital. The aim of the present study was to investigate the implementation process of the care pathway by comparing the experiences of health care professionals and managers in home care services between the participating municipalities. This was a qualitative comparative process evaluation using data from individual and focus group interviews. The Normalization Process Theory, which provides a framework for understanding how a new intervention becomes part of normal practice, was applied in our analysis. In all of the municipalities there were expectations that the generic care pathway would improve care coordination and quality of follow-up, but a substantial amount of work was needed to make the regular...
International Journal of Medical Informatics, 2009
Objective: To evaluate GPs use of three major electronic patient record systems with emphasis on ... more Objective: To evaluate GPs use of three major electronic patient record systems with emphasis on the ability of the systems to support important clinical tasks and to compare the findings with results from a study of the three major hospital-wide systems.
Family Practice, 1984
Using a one-stage random probability sample of households, 5806 people in an area of Norway were ... more Using a one-stage random probability sample of households, 5806 people in an area of Norway were interviewed about illness, use of medicines, self-treatment and visits to the doctor in the previous two weeks. Several social and demographic variables that might influence primary health care utilization were divided into five categories: need of medical care; self-care; availability of the doctor; sociodemographic factors; social network factors. Multiple classification analysis was used for the statistical analysis. The greatest influence on the percentage of people seeing the doctor was the need for medical care, the second largest influence was self-care. The availability of the doctor had a different effect according to whether the illness was chronic or non-chronic. Difficulties in reaching the doctor reduced the number of consultations for non-chronic diseases while the opposite was the case for chronic diseases. Among the sociodemographic variables neither level of education nor income had any influence on utilization when other variables were taken into account. Increasing age, however, caused a large increase in the percentage seeing the doctor, except after the age of 85 years when there was a large drop in consultation rate despite increasing illness. Social network factors had little effect on health care utilization.
BMC Medical Informatics and Decision Making, 2008
GPs, what constitutes the actual benefits and effects of the use of EPRs in the perspective of th... more GPs, what constitutes the actual benefits and effects of the use of EPRs in the perspective of the GPs and patients has not been fully characterized. We wanted to study primary care physicians' use of electronic patient record (EPR) systems in terms of use of different EPR functions and the time spent on using the records, as well as the potential effects of EPR systems on the clinician-patient relationship.
BMC Health Services Research, 2013
Background: Different models for care pathways involving both specialist and primary care have be... more Background: Different models for care pathways involving both specialist and primary care have been developed to ensure adequate follow-up after discharge. These care pathways have mainly been developed and run by specialist care and have been disease-based. In this study, primary care providers took the initiative to develop a model for integrated care pathways across care levels for older patients in need of home care services after discharge. Initially, the objective was to develop pathways for patients diagnosed with heart failure, COPD and stroke. The aim of this paper is to investigate the process and the experiences of the participants in this developmental work. The participants were drawn from three hospitals, six municipalities and patient organizations in Central Norway.
Quality & safety in health care, 2010
The objective of this study was to investigate whether implementation of multidose drug dispensin... more The objective of this study was to investigate whether implementation of multidose drug dispensing (MDD) for elderly outpatients is associated with a change in the number of discrepancies in the medication record at the general practitioners (GPs) and at the community home-care services. A controlled follow-up study with paired design of patients' medication records was performed during implementation of MDD. Medication records from the home care units and from the GPs were reviewed, and the discrepancies were noted. The discrepancies were rated into four classes based upon the potential harm, and a risk score system was applied, giving the potentially most harmful discrepancies the highest score. Medication records from 59 patients with a mean age of 80 years were included. The number of discrepancies was reduced from 203 to 133 (p<0.001), and the total risk score decreased from 308 to 181 (p<0.001) after the implementation of MDD. For both drugs subject to MDD and drugs ...
International journal of integrated care
To identify barriers to deployment of four articulated Integrated Care Services supported by Info... more To identify barriers to deployment of four articulated Integrated Care Services supported by Information Technologies in three European sites. The four services covered the entire spectrum of severity of illness. The project targeted chronic patients with obstructive pulmonary disease, cardiac failure and/or type II diabetes mellitus. One health care sector in Spain (Barcelona) (n = 11.382); six municipalities in Norway (Trondheim) (n = 450); and one hospital in Greece (Athens) (n = 388). The four services were: (i) Home-based long-term maintenance of rehabilitation effects (n = 337); (ii) Enhanced Care for frail patients, n = 1340); (iii) Home Hospitalization and Early Discharge (n = 2404); and Support for remote diagnosis (forced spirometry testing) in primary care (Support) (n = 8139). Both randomized controlled trials and pragmatic study designs were combined. Two technological approaches were compared. The Model for Assessment of Telemedicine applications was adopted. The proje...
BMC health services research, 2015
In Central Norway a generic care pathway was developed in collaboration between general hospitals... more In Central Norway a generic care pathway was developed in collaboration between general hospitals and primary care with the intention of implementing it into everyday practice. The care pathway targeted elderly patients who were in need of home care services after discharge from hospital. The aim of the present study was to investigate the implementation process of the care pathway by comparing the experiences of health care professionals and managers in home care services between the participating municipalities. This was a qualitative comparative process evaluation using data from individual and focus group interviews. The Normalization Process Theory, which provides a framework for understanding how a new intervention becomes part of normal practice, was applied in our analysis. In all of the municipalities there were expectations that the generic care pathway would improve care coordination and quality of follow-up, but a substantial amount of work was needed to make the regular...
International Journal of Medical Informatics, 2009
Objective: To evaluate GPs use of three major electronic patient record systems with emphasis on ... more Objective: To evaluate GPs use of three major electronic patient record systems with emphasis on the ability of the systems to support important clinical tasks and to compare the findings with results from a study of the three major hospital-wide systems.
Family Practice, 1984
Using a one-stage random probability sample of households, 5806 people in an area of Norway were ... more Using a one-stage random probability sample of households, 5806 people in an area of Norway were interviewed about illness, use of medicines, self-treatment and visits to the doctor in the previous two weeks. Several social and demographic variables that might influence primary health care utilization were divided into five categories: need of medical care; self-care; availability of the doctor; sociodemographic factors; social network factors. Multiple classification analysis was used for the statistical analysis. The greatest influence on the percentage of people seeing the doctor was the need for medical care, the second largest influence was self-care. The availability of the doctor had a different effect according to whether the illness was chronic or non-chronic. Difficulties in reaching the doctor reduced the number of consultations for non-chronic diseases while the opposite was the case for chronic diseases. Among the sociodemographic variables neither level of education nor income had any influence on utilization when other variables were taken into account. Increasing age, however, caused a large increase in the percentage seeing the doctor, except after the age of 85 years when there was a large drop in consultation rate despite increasing illness. Social network factors had little effect on health care utilization.
BMC Medical Informatics and Decision Making, 2008
GPs, what constitutes the actual benefits and effects of the use of EPRs in the perspective of th... more GPs, what constitutes the actual benefits and effects of the use of EPRs in the perspective of the GPs and patients has not been fully characterized. We wanted to study primary care physicians' use of electronic patient record (EPR) systems in terms of use of different EPR functions and the time spent on using the records, as well as the potential effects of EPR systems on the clinician-patient relationship.
BMC Health Services Research, 2013
Background: Different models for care pathways involving both specialist and primary care have be... more Background: Different models for care pathways involving both specialist and primary care have been developed to ensure adequate follow-up after discharge. These care pathways have mainly been developed and run by specialist care and have been disease-based. In this study, primary care providers took the initiative to develop a model for integrated care pathways across care levels for older patients in need of home care services after discharge. Initially, the objective was to develop pathways for patients diagnosed with heart failure, COPD and stroke. The aim of this paper is to investigate the process and the experiences of the participants in this developmental work. The participants were drawn from three hospitals, six municipalities and patient organizations in Central Norway.
Quality & safety in health care, 2010
The objective of this study was to investigate whether implementation of multidose drug dispensin... more The objective of this study was to investigate whether implementation of multidose drug dispensing (MDD) for elderly outpatients is associated with a change in the number of discrepancies in the medication record at the general practitioners (GPs) and at the community home-care services. A controlled follow-up study with paired design of patients' medication records was performed during implementation of MDD. Medication records from the home care units and from the GPs were reviewed, and the discrepancies were noted. The discrepancies were rated into four classes based upon the potential harm, and a risk score system was applied, giving the potentially most harmful discrepancies the highest score. Medication records from 59 patients with a mean age of 80 years were included. The number of discrepancies was reduced from 203 to 133 (p<0.001), and the total risk score decreased from 308 to 181 (p<0.001) after the implementation of MDD. For both drugs subject to MDD and drugs ...