**7. Conclusions**

The Primary Health Care Reforms currently under consideration reference the 'quadruple aim' of health care, improving: (1) people's experiences with health care; (2) population health; (3) cost-efficiency of the health system; and (4) work life for healthcare workers [49]. The first three of these are quantifiable measures that rely on the availability of relevant data, and statistical analysis of these data, to assess the effectiveness of any reforms implemented to achieve these aims.

There is a reliance on data currently contained in GP EHRs to answer these questions, as shown in the reform policy and in initiatives such as the Australian Institute of Health and Welfare's Primary Health Care Data Asset. Current forms of data extraction from EHRs might be economically preferable and can answer some questions, but they cannot answer all of them. The temptation to use these datasets may equate to 'trying to fit a square peg into a round hole', an idiom that implies a solution that is unfit for purpose. Rather than accepting or ignoring the limitations of EHR data that currently exist, why not be aspirational? How can we achieve better statistics from general practice that are able to inform both the patient and provider experience, and can be used for system planning?

COVID-19 has changed the way general practice services are conducted in Australia. The availability [50] and use [51] of telehealth services represents a dramatic shift in the way general practice services are provided to the public. However, there are little data available about how COVID-19 has changed the clinical activity undertaken by GPs and the quality of care provided through telehealth. Changes to the GP workforce resulting from COVID-19, and the future intentions of the GP workforce may have also been impacted by the pandemic, but with little data available it is impossible to quantify these. The approach presented in this paper for improving clinical activity data should be complemented by reinvestment in longitudinal data about the GP workforce, lost by the cessation of the MABEL study.

The approach to general practice data outlined in this paper may not answer every question that could be asked about general practice, but it would go a long way in overcoming the current deficiencies, and would produce national, valid, reliable statistics from Australian general practice.

**Author Contributions:** Conceptualization, J.G., H.B., G.C.M., J.H. and C.H.; investigation, J.G., H.B., G.C.M., J.H., A.S. and C.H.; writing—original draft, J.G., H.B. and G.C.M.; writing—review and editing, J.G., H.B., G.C.M., J.H., A.S. and C.H. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research received no external funding.

**Institutional Review Board Statement:** Not applicable.

**Informed Consent Statement:** Not applicable.

**Data Availability Statement:** Not applicable.

**Conflicts of Interest:** The authors declare no conflict of interest.
