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Each practice will be asked to collect baseline and quarterly data about the 50 enrolled patients using their existing Best Practice software. Practices will also be asked to allow the use of the MedicineInsight program to extract data regarding the 50 enrolled patients. Enrolled patients will be asked to consent to linked data being collected for 5 years after the 12-month trial ends.

Each practice will be renumerated on a per-patient basis for data collection, which we anticipate will most likely be conducted by a Practice Manager or Practice Nurse. Payments for data collection are calculated and paid separately to the quality improvement incentive payments. Data collection payments are made to the general practice, not to individual practitioners.

Linked data will be used for five years after the 12 month trial in order to measure long term outcomes for the 50 enrolled patients.

Surveys and interviews will also be used to collect data from patients and practice staff at baseline and the conclusion of the 12-month trial.

Quality incentive payments are incorporated into the outcomes-based funding model that will be implemented by practices in the intervention group only. The payments are linked to an increase in quality indicators including longer consultations, rapid follow up after hospitalisation and same-day access accompanied by demonstrated reductions in total prescriptions and selected pathology and imaging. The payments have been designed this way so the potential link between quality indicators and changes in outcomes can be explored.

The incentive payments are made on the basis of data collected both within the practice and externally by the MedicineInsight program. Incentive payments are made to practices.

Practices in the intervention group will be asked to: 

• Provide three longer consultations (longer than 15 minutes) to 30 enrolled patients (15 x >65 yrs & 15 x 18-65yrs with chronic illness) over the twelve-month trial period.
• Provide a follow-up appointment within one week of discharge after hospitalisation for 30 enrolled patients (15 x >65 yrs & 15 x 18-65yrs with chronic illness) over the 12 month trial period.
• Provide same-day access for acute conditions to 20 enrolled patients <16 yrs with an increased risk of hospitalisation over the twelve-month trial period.
• Reduce total prescriptions, as well as selected pathology and imaging tests used across the 50 enrolled patients.

Practices in the control group will be asked to:

• Collect baseline and quarterly data about the 50 enrolled patients using their practice software.

Researchers from the University of Wollongong, Monash University and the University of Tasmania have come together to develop and implement this project. Between them, the team have extensive experience in primary health care research and all four of the chief investigators are practicing general practitioners.

Professor Andrew Bonney, Project Lead & Chief Investigator
Prof Andrew Bonney is Roberta Williams Chair of General Practice at the University of Wollongong and a GP on the NSW south coast. Andrew’s research focus has been on the behaviours, delivery and organisation of primary health care, with a particular emphasis on improving care for vulnerable and underserved population groups. He has led a large and diverse portfolio of primary healthcare-related research projects, ranging from qualitative studies to program evaluations and randomised controlled trials. He is Director of the Illawarra and Southern Practice Research Network (ISPRN), a network of 50 general practices engaged in research in NSW and Tasmania.

Professor Nick Zwar, Chief Investigator
Nicholas Zwar MBBS, MPH, PhD, FRACGP is Dean of the School of Medicine, University of Wollongong. Nicholas Zwar is Dean, School of Medicine, University of Wollongong. Nick has substantial experience in health systems research for prevention and management of chronic illness and his work on chronic disease care planning in general practice and on asthma care has had an important influence on Australian health care policy. He has over 200 peer-reviewed publications. In the last five years, he has published 78 peer-reviewed journal articles, led the writing of two clinical practice guidelines, and authored three book chapters.

Professor Judy Mullan, Investigator
Judy Mullan is the Director of the Centre for Health Research Illawarra Shoalhaven Population (CHRISP) and the Deputy Director of the Illawarra & Southern Practice Research Network (ISPRN) She is an experienced academic, researcher and clinician with over 35 years’ experience as a registered pharmacist. Since joining UOW, she has established national and international research collaborations, published four book chapters, contributed to over 70 peer-reviewed journal articles and delivered over 100 national/international conference presentations.

Senior Professor Simon Eckermann, Health Economist
Simon Eckermann is Senior Professor of Health Economics at the Australian Health Services Research Institute, Sydney Business School and the University of Wollongong. His original research and international collaborations have established missing links between optimal decision making in research, reimbursement and regulation in practice and are extensively published in the highest impact health economics and decision making Journals, and clinical and policy journals along with his applied research. He is a CI on competitive research grants totalling more than A$25 million and undertakes guideline revision and health economics educational activities for National and International decision-making bodies.

Professor Marjka Batterham, Statistician
Associate Professor Marijka Batterham is the Director of the Statistical Consulting Centre at the University of Wollongong. Marijka is an Accredited Statistician with extensive experience in the design and analysis of many different types of clinically based projects in both hospital-based and community settings including parallel arm and clustered randomised trials and stepped wedge designs in addition to observational and cross-sectional studies. Her main focus has been on the design and analysis of lifestyle-based studies and handling missing data and attrition.

Doctor Athena Hammond, Investigator & Project Co-ordinator
Athena Hammond is a researcher who works predominately with qualitative and mixed methods. Her fields of specialty are birth unit design, shared decision making in primary care and practice-based research. Her research has been published and presented nationally and internationally and she has a particular interest in innovative qualitative methods.

Ms Alyssa Horgan, Project Support
Alyssa Horgan has worked for ISPRN for the last five years. Three of these years have been spent coordinating the activities of the research network. Prior to these, she held roles in the corporate and political sectors. Alyssa is currently undertaking a Bachelor of Communication.

Professor Grant Russell, Chief Investigator
Grant Russell is a primary care clinician and health services researcher. He is the Professor of Primary Care Research and Director of the Southern Academic Primary Care Research Unit (SAPCRU) within the Department of General Practice at Monash University. After completing training in 1989, he worked in general practice in Perth prior to leaving for Canada in 2005 to work at the Department of Family Medicine at the University of Ottawa, Canada. His research program is directed towards understanding and measuring the impact of primary care reform on patients, clinicians and general practices. He has been responsible for over 100 peer-reviewed publications and over $8,000,000 of research funding as a principal investigator.

Professor Danielle Mazza, Chief Investigator
Danielle Mazza is the Head of the Department of general practice and holds the Chair of General Practice at Monash University. Her major interest is in translational research, with particular focus on closing evidence-practice gaps in preventive care, women's sexual and reproductive health, and cancer screening and guideline development and implementation using patient-based strategies. During the course of her career, she has attracted over 3 million dollars in competitive funding as a chief investigator and has 48 publications in international and national refereed journals (34 as the first author). She is the author of the textbook 'Women's health in general practice', which is a recommended text for the RACGP's core curriculum. Danielle has methodological expertise in guideline development and the implementation, development, and trial of complex interventions.

Ms Catriona Rowe, Project Officer
Catriona is an experienced research officer who joined Monash University in 2006. She has worked in a number of clinical and research settings, throughout the Faculty of Medicine, Nursing and Health Sciences, most recently on the NHMRC funded ACCORd study. Catriona has a strong interest in primary health research, and its contribution to policy change and improved health outcomes for the community.

Associate Professor Jan Radford, Chief Investigator
Jan Radford is Associate Professor of General Practice at the University of Tasmania based in Launceston. She has worked as a GP in the same practice for 32 years and has a long history in curriculum development, delivery and assessment in medicine ranging from undergraduate to postgraduate training. She is Deputy Associate Head of the Launceston Clinical School and has developed a practice-based research network within northern Tasmanian general practices. She is currently a PhD candidate as well as provost of the RACGP Tasmania faculty, a member of the RACGP’s research and HANDI committees, current chair of the GP-North (Division of General Practice-northern Tasmania), and a member of Primary Health Tasmania’s clinical governance council. She is a 2017 Churchill Fellow.

Professor Gregory Peterson, Investigator
As Professor of Pharmacy and former Head of Pharmacy at the University of Tasmania, Greg has held a personal Chair at the University of Tasmania since 2000, awarded on the basis of his research and teaching excellence. Greg has led many state and national projects directed at improving the use of medications and patient outcomes in both community and hospital sectors. He is also Director of Health Services Innovation, School of Medicine. Greg has an international standing and record of accomplishment in the area of programs to promote the safe, rational and cost-effective use of medications. He has more than 450 papers published in refereed international and national journals and has been an editor/chapter contributor for 12 books. His research has received over $38M of external funds.

Dr Shandell Elmer, Project Officer
Shandell Elmer is a Senior Research Fellow within the School of Medicine, University of Tasmania, Australia. Shandell draws upon her work in a variety of settings including community nursing, health promotion, and general practice to inform the design of her research and curriculum. A strong advocate for primary health care, Shandell's work focuses on health literacy to improve the way that health service providers identify and respond to health literacy needs. She has worked within the health and community sector on a variety of research projects with a focus on quality improvement and health service design.

Gregory M. Peterson, Grant Russell, Jan G. Radford, Nick Zwar, Danielle Mazza, Simon Eckermann,
Judy Mullan, Marijka J. Batterham, Athena Hammond and Andrew Bonney. Effectiveness of quality incentive payments in general practice (EQuIP-GP): a study protocol for a cluster-randomised trial of an outcomes-based funding model in Australian general practice to improve patient care. BMC Health Services Research (2019) 19:529
Read the publication.

Australasian Academic Association for Primary Care’s (AAAPC) Annual Research Conference, Adelaide, 2019 – Poster Presentation
An inquiry into patient and general practice attitudes to financial quality-care incentives in primary care: pre-intervention data from the EQuIP-GP trial
Read the publication.

Society of Academic Primary Care 48th Annual Scientific Meeting, Exeter, UK, 2019 – Poster Presentation
What is the acceptability of sustainable, continuous quality incentives in primary care in the EQuIP-GP trial?