29 July 2026
For over a decade, Audit and Feedback (A&F) has been one of the most robustly evidenced quality improvement strategies in healthcare. A 2025 Cochrane review of 292 randomised trials found that structured feedback to clinicians produces a modest but meaningful average improvement in clinical practice of 6.2 percentage points, a figure that, at population scale, translates into substantial gains in patient outcomes.
Yet in Australian primary care, the infrastructure to deliver A&F at scale has been in retreat. The gap left since the winddown of the National Prescribing Service’s MedicineWise Practice Review and MedicineInsight programs has been felt by general practitioners. As one GP interviewed in the recent pilot observed, “The one thing that we used to have, which was fantastic, was a really, really high-quality data-driven reflection on our practice… that doesn’t exist anymore, so it’s a shame.“
A new research and development collaboration between Monash University, Eastern Melbourne Primary Health Network (EMPHN) and Outcome Health is seeking to fill that gap and, more ambitiously, to build a sustainable evidence-generating platform that keeps pace with the shifting landscape of general practice.
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A partnership built as an implementation laboratory
The Clinical Insights Program, piloted across 21 general practices in Melbourne’s east in late 2025, delivers tailored feedback reports to individual GPs based on routinely collected practice data held in the POLAR database. The design draws on international A&F theory including the Clinical Performance Feedback Intervention Theory (CP-FIT) and the Theoretical Framework of Acceptability and was co-designed with practising GPs through iterative user testing.
Two clinically significant, evidence-practice gaps were selected for the pilot: secondary prevention of cardiovascular disease following ischaemic stroke or TIA, and screening for chronic kidney disease in higher-risk populations. Both are areas where guideline-concordant care demonstrably lags, and where the potential population health return on modest behaviour change is high.
What sets this initiative apart from earlier efforts is how it is deliberately positioned as an implementation laboratory, a partnership that continuously refines the intervention while producing evidence that can be applied more broadly.
Signals of promise, and honest constraints
The formative evaluation, led by Monash University, engaged 30 GPs and nine non-GP practice staff through mixed-methods enquiry. All GP respondents indicated interest in receiving future reports, 83% considered the reports likely to improve patient care, and 80% rated them acceptable overall.
Just as importantly, the evaluation surfaced honest constraints: variable trust in underlying data, competing time pressures, and difficulties accessing linked patient lists. Only 37% of GPs rated reviewing the report a high or moderate priority a candid marker of the opportunity cost that quality improvement carries in a stretched primary care system.
A quiet reframing: quality improvement is a team sport
Perhaps the most consequential finding is one that reframes a long-standing assumption in A&F theory. Both GPs and non-GP staff, practice managers and nurses consistently described quality improvement (QI) as a whole-of-practice endeavour. Non-GPs frequently emerged as the operational engine of QI: extracting data, coordinating recalls, and translating clinician-level feedback into practice-level action.
This finding has implications well beyond the pilot. It suggests that future interventions designed solely around the individual clinician may under-realise their potential, and that future iterations should deliberately engage the wider practice team through parallel practice-level reports, tailored resources for non-GPs, and better integration with existing clinical workflows.
Toward a learning health system
The Clinical Insights pilot is an initial study, and its impact on clinical outcomes will be explored further in the next phase of evaluation. But its significance lies less in any single result than in the model it demonstrates: a Primary Health Network, a research-intensive university and a data custodian working in sustained partnership to close the loop between evidence, practice and reflection.
If that model holds, it offers a scalable answer to a question the Australian primary care sector has been asking for some years now: how do we systematically help clinicians see their own practice clearly, and act on what they see?
