On 12 November, the Australian Commission on Safety and Quality in Health Care published its ‘Atlas Focus Report: Osteoarthritis of the knee’ national data report, which examines MBS-subsidised knee imaging, hospitalisations for knee arthroscopy and hospitalisations for knee replacement surgery, for people aged 45 years and over. Osteoarthritis of the knee can cause inflammation in knee joints, leading to pain and disability, with around 1.9 million Australians living with it. A common condition, for most people who live with it, the diagnosis can be made with a history and examination and, unless they have severe and persistent pain that is affecting their daily life, knee replacement surgery is avoidable. About knee osteoarthritis (click to enlarge). Source: Australian Commission on Safety and Quality in Health Care A substantial 83% increase in knee CT scans and a 26% increase in knee ultrasounds for people aged 45 years and over, in the five years to 2023–24, is revealed by the data, the Commission said. The Commission also noted that the report “showed an encouraging 50% reduction in knee arthroscopy rates in the 10-year period to 2023–24, in line with guideline recommendations against its use for uncomplicated osteoarthritis of the knee”. Imaging rates and surgical interventions (click to enlarge). Source: Australian Commission on Safety and Quality in Health Care Meanwhile, knee replacement surgery, which should be reserved for people living with persistent severe pain and disability, rose 17% in the past decade. “For people with knee osteoarthritis, effective care starts with a good clinical assessment. A thorough history and examination tell you more than CT scans, ultrasounds, X-rays, MRIs or blood tests,” said Medical Advisor for the Commission and general practitioner Dr Phoebe Holdenson Kimura. “We don’t recommend tests such as CT scans or ultrasounds for knee osteoarthritis as they offer little benefit and there is poor correlation between severity of symptoms and radiology findings. They can also lead to undue concern and inappropriate further tests, specialist referrals and surgery. “Let’s get things right from the outset — current evidence shows that non-surgical interventions should always be first line, and are safe and beneficial. Knee joints are designed to be loaded and are nourished with movement,” Holdenson Kimura said. Dr Phoebe Holdenson Kimura. Source: Australian Commission on Safety and Quality in Health Care The total annual cost of osteoarthritis in Australia is $4.3 billion, with unnecessary or low-value scans and treatments for knee osteoarthritis contributing to this, the Commission said. The Commission also said that more work is needed to change mindsets, as two-thirds of these people do not receive effective care such as education, exercise and weight management. 3 steps to improve care for knee osteoarthritis (click to enlarge). Source: Australian Commission on Safety and Quality in Health Care First released in 2017 to improve care for knee osteoarthritis and to reduce inappropriate interventions, the Commission’s Osteoarthritis of the Knee Clinical Care Standard was updated in 2024, encouraging patients to take control of their health and clinicians to avoid referring for unnecessary scans, surgical intervention or over-reliance on pain relief medicines. “Instead, it urges greater focus on supporting patients with weight management, nutrition, physical activity and exercise,” the Commission said. You can find more information on the report at www.safetyandquality.gov.au/data-and-measurement/australian-atlas-healthcare-variation/atlas-focus-report-osteoarthritis-knee. Top image credit: iStock.com/stefanamer

“Violence in our hospitals is unacceptable — accounts of these incidents are distressing and we are determined to clamp down on these occurrences,” said NSW Health Minister Ryan Park on 11 November, confirming that the NSW Government will recruit an additional 129 full-time-equivalent frontline security staff. Part of a $113 million investment, the recruitment will result in full-time security across 27 hospitals across the state, the government said. “We have made significant efforts to improve security at our hospitals over the past three-and-a-half years,” Park also said, with the government advising that since 2023, it has recruited 180 security staff at NSW public hospitals — a 13% increase. “Today, I can announce we are boosting these efforts by recruiting a further cohort of frontline security staff — a first step in an ongoing effort to improve safety — and we will continue to work closely with the HSU,” Park added. Regarding the announcement, NSW HSU (Health Services Union) Secretary Gerard Hayes said: “Emergency departments are the main gateway to patients entering our health system and one of the busiest areas that can lead to incidents of aggression and violence. “This first step is a positive one, but our members need to have more support and the ability to prevent incidents from occurring in the first place.” To support the prevention and management of violence, the government said that NSW Health facilities already have several key strategies in place. These include: ​early recognition and management of a patient at risk of escalating behaviour; making risk-related information available to all relevant staff, as well as violence-prevention and management education for staff; safety huddles at the commencement of each shift; proactive security staff patrolling; enabling staff to summon assistance; limiting unauthorised access by individuals to clinical areas; and closed circuit television monitoring in high-risk areas.   Image credit: iStock.com/Jacob Wackerhausen

Healthcare-associated infections (HAIs) remain a significant challenge for acute care hospitals, with considerable attention traditionally focused on bloodstream infections, surgical site infections and antimicrobial resistance. Yet one of the most common HAIs receives little attention: non-ventilator hospital acquired pneumonia (NV-HAP).1 NV-HAP occurs in hospitalised patients who are not receiving mechanical ventilation and is associated with substantial increases to patient morbidity, mortality and healthcare costs. In fact, patients who develop NV-HAP may remain in hospital longer (commonly 8–14 days) and are eight times more likely to die during their admission.2 Despite this burden, NV-HAP is infrequently monitored, inconsistently reported and rarely targeted through formal infection prevention programs. Recent findings from The Hospital Acquired Pneumonia PrevENtion (HAPPEN) Trial provide some of the strongest evidence to date that improving oral care can significantly reduce NV-HAP incidence in acute care settings.3 Why oral care matters The oral cavity contains billions of microorganisms. During hospitalisation, oral health deteriorates due to illness, immobility, reduced self-care capacity, medication effects, dehydration and inadequate oral hygiene. These changes can promote bacterial colonisation of the teeth, gums and tongue.4 When oral secretions containing pathogenic bacteria are aspirated into the respiratory tract, pneumonia can develop. This mechanism is well-established and has led many guidelines to recommend oral care as part of pneumonia prevention strategies. However, until recently, high-quality randomised control trial evidence supporting these recommendations in non-ventilated hospital patients was limited.4 Research has consistently shown that oral care is frequently missed or inadequately performed in acute care settings. Common barriers include competing clinical priorities, limited staff knowledge, insufficient resources, lack of documentation and uncertainty regarding responsibility for oral care delivery.5, 6 The HAPPEN Trial The HAPPEN Trial was designed to address these evidence gaps by evaluating whether an enhanced oral care intervention could reduce NV-HAP among hospitalised patients.3 Conducted across three Australian hospitals, the multicentre stepped-wedge cluster randomised trial involved nine in-patient medical wards. Eligible participants were adults admitted to participating wards for at least 48 hours. A total of 8870 patients were included in outcome analyses. It was the biggest trial undertaken to take. Image: Supplied Core components The intervention consisted of three core components: 1. Oral care resources and maintenance Patients admitted to intervention wards received toothbrushes, toothpaste and supporting educational materials. Patients were encouraged to undertake oral care (brushing of teeth, gum and tongue and/or dentures with fluoride toothpaste). Research nurses assisted with oral care where required. 2. Education Patients and healthcare workers received education on the importance of oral care and its role in preventing NV-HAP. They were also provided access to resources, now located on a new website (www.happenstudy.com). This website also offers freely available educational resources, including instructional videos, practical guides, and implementation materials for hospital, clinical staff, infection control staff and patients. 3. Documentation, audit and feedback Documentation of patient oral care was encouraged throughout the intervention. Regular audits of oral care documentation were undertaken, and feedback was provided to support practice improvement. Importantly, the intervention sought to facilitate and strengthen routine oral hygiene practices rather than introduce specialised equipment or advanced technologies. Key findings The primary outcome was NV-HAP incidence, defined using established European Centre for Disease Prevention and Control criteria. Among 8870 analysed patients, 78 cases of NV-HAP were identified. Forty-six cases occurred during the control phase and 32 during the intervention phase. Statistical analysis demonstrated that exposure to the intervention reduced NV-HAP risk by approximately 60%, with a hazard ratio of 0.40 (95% CI 0.19-0.82). The intervention also had a substantial impact on oral care practice. Documented completion of oral care protocols increased from approximately 16% before implementation to 62% following intervention rollout with oral care being undertaken on average twice daily. The findings are clinically significant because they demonstrate that improving oral care behaviour can translate into meaningful reductions in HAIs. Impact on hospital outcomes. Click to enlarge. Image: Supplied Implications for infection prevention programs The HAPPEN Trial has several important implications for infection prevention and control professionals. NV-HAP deserves greater attention While hospitals routinely monitor many HAIs, NV-HAP often remains invisible within surveillance systems. The demonstrated burden of disease suggests that hospitals should consider incorporating NV-HAP into quality improvement and patient safety initiatives. Oral care should be viewed as infection prevention Oral care is frequently regarded as a nursing comfort measure. However, the HAPPEN findings reinforce that oral care is also an infection prevention intervention with measurable clinical outcomes. Hospitals may benefit from reframing oral care as a core patient safety activity rather than an optional aspect of personal hygiene. Implementation matters The HAPPEN intervention was not dependent on expensive technology. Instead, success relied on education, product availability, patient engagement and regular documentation and feedback. The study demonstrates that relatively simple implementation strategies can improve adherence and produce meaningful clinical benefits. Multidisciplinary collaboration is essential Success required collaboration between nursing teams, infection prevention professionals, research educators, hospital administrators and consumers. Sustainable implementation is likely to require similar multidisciplinary partnerships. Three strategies to prevent pneumonia. Click to enlarge. Image: Supplied ************************************************** Practical considerations for healthcare facilities For organisations seeking to strengthen NV-HAP prevention efforts, several practical lessons emerge: Ensure oral care products are readily available. Incorporate oral care into patient admission processes and documentation throughout a patient’s admission. Educate staff about links between oral care and pneumonia prevention. Support patients who require assistance with oral hygiene. Audit oral care delivery and provide regular feedback. Consider oral care compliance as a patient safety indicator.   Importantly, oral care interventions are low-cost, scalable and compatible with existing clinical workflows. ************************************************** Looking ahead The HAPPEN Trial provides robust evidence supporting enhanced oral care as an effective strategy for reducing NV-HAP in hospitalised patients. The findings contribute significantly to an area where high-quality evidence has historically been limited. Future work will further explore implementation, patient experiences and cost-effectiveness outcomes. However, the clinical message is already clear: improving oral care can reduce pneumonia risk among hospitalised patients. As healthcare systems continue to seek effective, scalable and cost-conscious approaches to infection prevention, oral care represents an intervention that is simple, practical and supported by strong emerging evidence. In an era increasingly focused on high-tech healthcare solutions, the HAPPEN Trial demonstrates that basic nursing care remains one of the most powerful tools available for improving patient safety. You can learn more about the study at www.happenstudy.com. *Georgia Matterson is a member of the research team on the HAPPEN Trial and Research Assistant at Avondale University. †Professor Brett Mitchell is a Chief Investigator on the HAPPEN Trial and Professor of Health Services Research & Nursing at Avondale University. 1. Munro SC, Baker D, Giuliano KK, et al. Nonventilator hospital-acquired pneumonia: a call to action. Infect Control Hosp Epidemiol. 2021;42(8):991–996. doi: 10.1017/ice.2021.239 2. Chalker MA, Browne K, Russo PL, Mitchell BG. Impact of non-ventilator healthcare-associated pneumonia on mortality and additional length of stay in adults admitted to an acute care hospital: a systematic review. J Hosp Infect. 2026;170:122–138. doi: 10.1016/j.jhin.2026.01.013 3. White NM, Russo PL, Matterson G, et al. Effectiveness of oral care for the prevention of non-ventilator hospital-acquired pneumonia (HAPPEN): a multicentre, stepped-wedge, cluster-randomised trial in Australia. Lancet Infect Dis. 2026;26(10):1022–1030. doi: 10.1016/S1473-3099(26)00235-5 3. Ehrenzeller S, Klompas M. Association between daily toothbrushing and hospital-acquired pneumonia: a systematic review and meta-analysis. JAMA Intern Med. 2024;184(2):131–142. doi: 10.1001/jamainternmed.2023.6638 5. Tehan P, Browne K, Matterson G et al. Oral care practices and hospital-acquired pneumonia prevention: a national survey of Australian nurses. Infection, Disease & Health, 2024;29:212–217. doi: 10.1016/j.idh.2024.04.006 6. Rawson H, Dawson S, Madhuvu A, et al. Nurses’ experiences of providing oral care to hospitalised patients: a qualitative study. Infect Dis Health. 2025;30(4):343–352. doi: 10.1016/j.idh.2025.05.002 Top image: Supplied

Australian hospitals and healthcare organisations are adopting digital solutions, including artificial intelligence, at pace to streamline clinical workflows and enable more connected and personalised health care. Continuous glucose monitoring (CGM) is a good example. For people living with type 1 diabetes, CGM is already well established, but as access and awareness expand, its role for people living with type 2 diabetes is also becoming increasingly relevant to primary care. The RACGP’s current guidance1 recommends that CGM be considered for people living with type 2 diabetes using intensive insulin therapy, subject to individual circumstances and available resources. It also recognises the value of CGM in providing greater insight into glycaemic variability and patterns. That creates an important shift for clinicians because CGM is no longer simply a specialist technology that sits within endocrinology. As its use for people living with type 2 diabetes grows, clinical specialists will increasingly discuss where CGM is appropriate, how the data should be interpreted and how this information can inform ongoing healthcare management. From specialist to mainstream care One of the biggest benefits CGM brings to mainstream health care for people living with diabetes is the move from periodic measurement to continuous visibility. HbA1c remains an important measure of longer-term glycaemic control, but it cannot show a clinician what happened between patient appointments. CGM can reveal patterns that may otherwise remain hidden: recurring post-meal rises, overnight changes, periods of hypoglycaemia or the relationship between glucose, physical activity and treatment. For a clinician, the value is not in having hundreds of additional readings to review. It is in being able to identify the information that can change the conversation with a patient. That requires a shift in mindset. The clinical view now needs to focus on what CGM data can reveal about a patient at a deeper level and how their healthcare management should change to improve their overall health outcomes. Primary care needs CGM that works around the patient Bringing CGM into mainstream care also means recognising that technology needs to work for the realities of people’s lives. For example, how quickly a sensor begins providing information matters. Alerts need to be useful rather than simply frequent. Configurable high and low alerts, predictive information and options to manage notifications can help clinicians and patients tailor the CGM to individual needs and avoid unnecessary alarm fatigue. Importantly, data needs to be accessible beyond the patient’s phone. The ability to share glucose information remotely and generate reports showing patterns over time can support clinical conversations. None of these features is the objective in itself. Their value comes from whether they make it easier for a person to use a CGM consistently and for a clinician to turn the resulting information into appropriate action. The opportunity is bigger than glucose monitoring Medical researchers are now increasingly recognising the value of CGM in primary health care. A 2024 umbrella review published in Archives of Public Health, which consolidated findings from 31 systematic reviews, examined the effectiveness of CGM compared with conventional blood glucose monitoring or usual care. Its analysis found an average HbA1c reduction of 0.40 percentage points and a six percentage-point increase in time in range associated with CGM use. The researchers assessed the overall certainty of evidence as moderate, while noting that further research is needed to better understand patient experience and acceptability.2 Studies like this demonstrate how continuous glucose information has the potential to move conversations beyond managing an established diagnosis and towards understanding how everyday behaviours affect metabolic health. The next phase is integration Australia now has an opportunity to take a more holistic approach to CGM. For people living with type 1 diabetes, the evidence demonstrates that CGM can support both glucose management and the lived experience of managing the condition. For people living with type 2 diabetes, an expanding evidence base is demonstrating benefits when CGM is incorporated into primary care. Emerging research is also exploring whether the technology could have a role even earlier, helping people understand metabolic risk. As CGM reaches more people living with diabetes, primary care will have an increasingly important role in making sure the technology is used appropriately, supported effectively and connected to the broader healthcare journey. *Leeane Beasley is Director Commercial Operations at Dexcom Australia. 1. Royal Australian College of General Practitioners. Management of type 2 diabetes: use of technology in type 2 diabetes management. Accessed November 2, 2026. https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/management-of-type-2-diabetes/use-of-technology-in-type-2-diabetes-management 2. Tan YY, Suan E, Koh GCH, et al. Effectiveness of continuous glucose monitoring in patient management of type 2 diabetes mellitus: an umbrella review of systematic reviews from 2011 to 2024. Arch Public Health. 2024;82:231. doi: 10.1186/s13690-024-01459-2 Top image credit: iStock.com/RgStudio. Stock image used is for illustrative purposes only.

Namoli Healthcare’s Medical Centre Cleaning service is built for medical centres, GP offices and specialist clinics, with a cleaning plan tailored to each practice’s patient flow and compliance needs. The service covers waiting rooms and reception, consultation and treatment rooms, washrooms and staff areas, with targeted disinfection of high-touch surfaces such as door handles, light switches, counters and payment terminals. Cleaning is scheduled around patient appointments to keep disruption to a minimum. Namoli’s teams are trained in clinical hygiene, cross-contamination prevention, confidentiality and safety. They use TGA-approved, hospital-grade disinfectants and colour-coded equipment, and follow the Australian Guidelines for the Prevention and Control of Infection in Healthcare to support each practice’s own infection control policy. Designed so that results are measured, not assumed, clinical audits combine visual inspections with ATP surface testing and protein swabs, and results are recorded digitally, which is designed to give practice managers clear evidence to track over time and keep the practice audit-ready. For more information and to book a free consultation for your practice: https://www.namolihealthcare.com.au/healthcare-cleaning/medical-centre-cleaning/.

If you manage a medical centre, try tracing one cleaning task from the room schedule to the completion log. Can you tell who was responsible, which method they used and what happened if the task was missed? That simple check can expose gaps between the practice’s infection prevention policy and what happens on site. The Royal Australian College of General Practitioners (RACGP) has published the 6th edition of its Standards for general practices. The Australian Commission on Safety and Quality in Health Care says assessments under the National General Practice Accreditation Scheme still use the 5th edition, with transition arrangements to follow. Facilities managers can use the new guidance now to review cleaning arrangements while maintaining evidence for their next assessment. In a mixed healthcare facility, confirm which services fall under the general practice standards and which follow a different accreditation framework. What the new edition means for cleaning Criterion CG9 covers infection prevention and control (IPC). CG9.A calls for a current written policy tailored to the practice. Its guidance covers environmental cleaning in clinical and non-clinical areas, along with spills, waste and staff responsibilities. CG9.B assigns the IPC coordinator role to a clinical team member. For facilities managers, that gives the cleaning provider a clear point of contact when a routine task involves a clinical risk or needs escalation. Under criterion CG10.A, practices need a cleaning policy aligned with the RACGP’s Infection Prevention and Control Guidelines or another relevant Australian standard. Translate that policy into instructions for each room and surface. A waiting room, a treatment room and a staff kitchen have different patterns of use, and those differences should shape the frequency, products and methods in the schedule. Pay particular attention to the handover between clinical staff and contractors. A contractor may clean consultation room floors after hours, while a practice team member handles an examination couch between patients under the practice’s protocol. The schedule should show who owns each task and who responds if a spill or suspected contamination occurs during opening hours. Five cleaning records to keep 1. Approved policy and risk assessment. Keep the current version, approval date and review date. Identify clinical and non-clinical areas, frequently touched surfaces and tasks that need a different response when contamination is suspected. Record who can approve changes to cleaning methods and when the team should escalate a concern. 2. Room-by-room cleaning schedule. List the area or surface, frequency, method, product, equipment and responsible role. Include both planned work and tasks triggered by use or an incident. Keep the schedule consistent with the contract so cleaners and practice staff see the same division of responsibilities. 3. Completion logs and exception records. Record what was done, when and by whom. If a room was locked or a task was missed, record the reason, who was notified and when the work was completed. For an incident that affects room availability, document the response and who authorised the room to return to use, where required. 4. Product, equipment and training records. Keep a product register with approved uses, dilution where relevant, manufacturer instructions and safety data sheet locations. Record staff induction and refresher training on site procedures, equipment, personal protective equipment and escalation. Match products to the surface and task, including where the risk assessment calls for disinfection. 5. Audit findings and corrective actions. Record the area checked, the method, what the reviewer found and who owns the follow-up. If a check finds the same surface is repeatedly missed, investigate access, timing or unclear instructions. Document the change, then repeat the check to see whether it worked. For teams managing more than one site, use the same record format across practices and keep the schedules local. A central register can show which site has reviewed its policy, where training is due and which audit actions remain open. The local schedule still needs to reflect each site’s hours, room use and access arrangements. Give relief staff access to the current version at the point of work so a change in roster does not turn into a missed task. Test the records against a normal shift Pick one consultation room and follow its cleaning schedule through a full day. Ask clinical staff and cleaners to identify their own tasks, observe a handover and compare what happened with the completion log. A between-patient task may have no clear owner, or a cleaner may be scheduled before the last consultation ends. Either finding gives you something specific to fix. Keep the records somewhere the practice manager and IPC coordinator can access. Review the schedule when rooms, services or patient flow change, and agree with your accrediting agency which edition applies to the next assessment. Read Namoli Healthcare’s full guide to RACGP cleaning and infection prevention evidence.

RMIT University researchers and Melbourne-based medtech company Sleeptite have collaborated on a recent study that suggests fabric-embedded pressure sensors can be manufactured using scalable production techniques while maintaining performance and durability — the technology is designed to monitor residents’ wellbeing in healthcare settings and identify falls risk so carers can intervene. The FlexiSense technology, which Sleeptite is developing for use in its REMi in-bed monitoring system, measures bed position and posture via soft, flexible electronics in mattress protectors and is designed to help care staff respond sooner to the risk of falls, with detection of pressure sore risk in development. In October 2026, a US patent was granted, following almost a decade of collaboration led by Sleeptite, working with RMIT and manufacturing partner Sleepeezee Bedding Australia. “Care workers can’t be in every room, every minute of the night. This technology gives them an extra set of eyes, without putting a camera in the room,” Sleeptite founder and CEO Cameron van den Dungen said. “It helps carers spot risks earlier, so they can step in before a fall happens, and it gives the people in their care, and their families, real peace of mind.” Designed to allow residents to be monitored non-invasively without changing their daily routines, and unlike camera-based monitoring systems or wearable devices, FlexiSense is built directly into mattress protectors. Detecting changes in applied force through the material’s piezoresistive qualities, the sensors are fabricated using silver and carbon ink on flexible polyurethane sheets. “The sensors can be used across a wide range of mattress types, making the technology easier and more affordable to adopt,” said sensors designer Distinguished Professor Madhu Bhaskaran from RMIT University. “Through rigorous testing under the rollator machine, our ready-to-manufacture sensors have demonstrated durability, sensitivity and robustness, accurately detecting body motion with minimal power consumption.” Professor Madhu Bhaskaran holding one of the flexible sensors invented at RMIT. Image: Supplied A paper on the sensors was published open access in Flexible and Printed Electronics and you can read it at doi.org/10.1088/2058-8585/ae8e8c. Top image: The flexible sensors in bedding. Image: Supplied

Information is moving between systems, but workflows remain fragmented. Clinicians are still having to search across systems, interpret long PDFs, rekey information captured elsewhere and question whether information can be trusted. This is the paradox at the centre of digital health today: we are more connected than ever, but still not coordinated. The challenge is no longer whether information can move, but whether it is surfaced at the right time, with enough meaning, context and trust to support care. Moving information is only the first step For years, interoperability centred on establishing connections: could a discharge summary reach general practice or a residential aged care facility, or a diagnostic report be uploaded and retrieved? Those capabilities remain important, but simply moving information does not guarantee it will be useful. For information to support the next step in care, its meaning, context and provenance must travel with it. The receiving system and clinician need to understand what the information means, the circumstances in which it was captured, where it came from and how current it is. That is why the next chapter of interoperability cannot simply be measured by the number of connections we have built. It must be measured by whether those connections make care safer, faster and more coordinated. What happens when people become the integration layer Those gaps are tangible in everyday workflows. A clinician building a current view of a person’s care may need to reconcile medication histories, discharge summaries, pathology results and specialist letters before confidently making a care decision. In effect, people can become the integration layer between systems. For technology decision-makers, this is an important test of interoperability. If people still need to manually transfer or reconcile information between systems, the workflow remains fragmented. Over time, both fragmented information and workflows make continuity of care more difficult to maintain and create additional work for both clinicians and patients. A coordinated care experience should do the opposite: reduce the work on both sides, give clinicians and care providers confidence in their data and help all of us feel more understood when receiving care. ************************************************** What this looks like in practice eRequesting Consider one of health care’s most routine transactions: a pathology request. This workflow still largely relies on highly manual processes such as printing PDFs and rekeying information. Structured eRequesting creates a coordinated flow. A request is created once from information already in the clinician’s system and moves as usable, structured data. This supports an automated end-to-end process in which information flows both ways, results are matched to the original request and fewer steps require manual intervention. It sounds simple, and that is exactly the point. Some of the most valuable interoperability does not look like a major technology disruptor. It looks like an everyday process, becoming easier. Supporting residents through earlier recognition of deterioration Now, let’s take the same pattern into residential aged care. A resident’s daily observations, notes and medications are recorded consistently inside the facility, but deterioration in older people often builds quietly over days. In most cases, the facility’s systems already hold enough data to signal that a resident is deteriorating — but that data isn’t in one place, and there simply isn’t the time for staff to review each resident, every day, to identify these emerging patterns. A consolidated, dynamic view of those observations, notes and medications could help care teams see changes in a resident’s condition earlier, prompting review and supporting earlier intervention before the resident’s condition deteriorates further. ************************************************** Building the foundation for what comes next Health care needs standards-based, FHIR-native infrastructure so that clinical information retains its meaning as it moves. It must work with existing systems and embed governance, consent, provenance and audit in the information itself. This may be less glamorous than the technologies attracting attention, but it’s critical to making clinical information both safe and useful. Many organisations are exploring how AI can support care through ambient documentation, clinical summaries, decision support and new models of care. But advanced technology cannot compensate for incomplete clinical data; it scales its weaknesses. Outputs built on fragmented records, missing histories or unverified information inherit those flaws, only faster and with unearned confidence. Quality data and strong, standards-based interoperability foundations help ensure these emerging technologies can deliver meaningful, usable information at the point of care, and the ability to scale across other workflows. The next interoperability solve: context, meaning and coordinated care The opportunity now is to reframe interoperability from the connection itself to the value of information when it arrives. Does it remove the need to search, reconcile and reconstruct what has already happened? Is the information presented at the right time? Ultimately, does it reduce the work required to enable coordinated care? That is interoperability’s real value — and its original promise. *Jennifer Beer is Product Executive at Telstra Health. Top image credit: iStock.com/Noko LTD

In the context of its proposed acquisition of Newcastle Private Hospital and Hunter Valley Private Hospital, on 5 November, Calvary Health Care confirmed that “some services currently available at the two hospitals will not be offered by Calvary”. “These include in vitro fertilisation (IVF) and other assisted reproductive technologies, voluntary assisted dying (while complying with all relevant legislative obligations), elective terminations of pregnancy, and gender reassignment procedures,” Calvary said in a statement. “Sterilisation and contraceptive procedures are not offered where fertility prevention is their sole purpose. Where Calvary is unable to offer a particular service, admitted patients will continue to receive all other care and support.” Saying that the acquisitions will provide greater stability for the hospitals, their employees and the communities they serve, Calvary said: “We expect most services to continue. As a Catholic healthcare organisation, Calvary’s approach to care is guided by the Code of Ethical Standards for Catholic Health and Aged Care Services in Australia.” In the same statement, Calvary acknowledged “concerns and uncertainty” within the community regarding the proposed acquisition, adding that it is “aware this has created questions for patients, clinicians, staff and the broader community”. “We recognise that changes to some services will have implications for clinicians and the patients they care for,” Calvary Health Care CEO Damien Bruce said. “We are having active discussions with local clinicians to understand those impacts and are committed to working with relevant healthcare providers to explore appropriate pathways for patients.” Image credit: iStock.com/blackdovfx

Supplying equipment to Australia’s healthcare and aged care sectors can be a significant opportunity for small, medium and large equipment supply businesses across Australia. Hospitals, aged care facilities and government health departments regularly purchase everything from medical equipment and hospital beds to mobility aids, furniture and specialised technology. Factors such as local economic contribution, environmental sustainability, installation processes and staff training can all influence the outcome of a tender even when they have limited real impact on the performance of the product. For Australian businesses bidding for government contracts, this can mean having an excellent product at a competitive price is not enough to win a contract — especially a government contract. Understanding these additional requirements, and developing practical ways to address them, can make a significant difference when competing for healthcare and aged care contracts to local government, state government, the federal government and sometimes the private sector. 1. Local content: demonstrating your contribution to the community One challenge facing equipment suppliers is meeting local content requirements. Many Australian government procurement processes encourage suppliers to demonstrate how their contracts will benefit the local economy. Depending on the state, territory and particular procurement policy, this might involve local employment (for example, for installing hospital beds), purchasing general supplies from local businesses or establishing a presence in the region (such as a warehouse presence for distribution). This can be particularly challenging for businesses bidding for contracts outside their home state. For example, a medical equipment supplier based in New South Wales might be bidding to supply hospital beds to a healthcare network in Victoria. Although the supplier may offer an excellent product, competing against businesses with an established Victorian presence can be difficult as they will often score better for local content given their Victorian presence. There are practical ways to address this. Suppliers can consider establishing a local office, engaging local installation and maintenance contractors, or partnering with businesses already operating in the region. Another approach is transferring knowledge and technical expertise to local workers. This could involve training local technicians to install, service and maintain equipment, creating ongoing benefits beyond the initial supply contract. When writing the bid or tender, businesses need to explain these commitments clearly in their tender responses. Rather than simply stating that they support local businesses, suppliers should identify the specific activities they intend to undertake, the businesses they plan to engage and the benefits their approach will deliver. 2. Environmental sustainability: small weightings can make a big difference Environmental sustainability is another area that suppliers sometimes underestimate. In some state government tenders, environmental criteria may account for only 5% of the overall evaluation. While this might appear relatively insignificant, that small percentage can become the deciding factor when two suppliers offer similar products at comparable prices. For healthcare equipment suppliers, environmental considerations can include packaging, waste management, recycling, transport emissions, product durability and responsible disposal. A common challenge is that smaller suppliers may not hold formal environmental certifications such as ISO 14001. However, not having certification does not necessarily mean a business lacks effective environmental practices. Many suppliers already have robust procedures for reducing waste, recycling packaging, managing materials and limiting their environmental impact. The problem is that these practices are not always formally documented. One practical solution is to develop an environmental management policy and supporting procedures that reflect the relevant principles of ISO 14001. Suppliers should clearly describe their existing environmental initiatives and provide evidence of how these are implemented. For businesses planning to compete regularly for larger government contracts, pursuing formal certification may also be worthwhile. Even where certification is not mandatory, demonstrating that the business has commenced a structured certification process can help communicate a commitment to continuous improvement. A letter from an ISO certifier confirming an engagement provides further credibility to your bid. Environmental sustainability should not be treated as an afterthought — equipment supply tenders are highly competitive, and it has an impact on the result and overall weighting criteria. 3. Installation, training and communication: thinking beyond delivery Another challenge facing health and aged care equipment suppliers is demonstrating how their products will be successfully introduced into a health and aged care environment. Consider a business supplying adjustable beds to an aged care facility. The beds might be exceptionally well designed, competitively priced and compliant with all relevant technical requirements. However, the purchasing organisation also needs confidence that staff will understand how to operate them safely and that residents will receive appropriate support. This is where installation, training and communication become important and a tailored approach needs to be taken. Australia’s healthcare and aged care workforce is culturally and linguistically diverse. Staff, residents and patients may speak different languages or have varying levels of familiarity with specialised equipment. Suppliers can differentiate themselves by providing clear operating instructions, visual guides, training videos and translated materials in languages relevant to the facility. For example, a supplier might offer multilingual instructions explaining how to adjust a bed, operate its safety features or identify when maintenance is required. Training sessions can also be tailored to different users, including nurses, carers, maintenance personnel and facility managers. Beyond installation, suppliers should consider how they will manage ongoing communication, technical support, spare parts and equipment servicing. These measures demonstrate that the supplier understands the practical challenges facing health and aged care providers and provides businesses the opportunity to tailor their bids to the client. Rather than simply delivering equipment, the business is offering a complete solution that supports staff, patients and residents. 4. Looking beyond the product The common theme across these challenges is that tendering involves much more than demonstrating product quality. Healthcare organisations are not simply purchasing equipment. They are assessing the overall capability, reliability and suitability of the businesses supplying it. They want confidence that suppliers can meet contractual obligations, contribute to broader procurement objectives and support the people who will ultimately use their products. For businesses, this requires preparation well before a tender is released. Developing environmental policies, building relationships with local suppliers and preparing comprehensive training materials can all strengthen future submissions. It is also important to carefully review each tender’s evaluation criteria, mandatory requirements and supporting documentation. A strong response should directly address what the buyer is asking for, supported by specific examples and evidence rather than general statements. *Jason Cooney is Director of The Tender Team. Top image credit: iStock.com/Halfpoint

Designed as a people-centric approach to redevelopment and expansion of an existing hospital, the Frankston Hospital Redevelopment on Victoria’s Mornington Peninsula — completed for the Victorian Health Building Authority in partnership with the Exemplar Health consortium and Bayside Health — opened in January 2026 as Peninsula University Hospital. Image: Peter Clarke Image: Peter Clarke The new 12-storey tower and podium was planned to ‘optimise connectivity’ between the existing hospital and the new acute tower, the facility designed to ensure key separation of public and clinical flows — enabling a functional and dignified patient and staff experience. Image: Peter Clarke The interior intends to create an uplifting, calm and intuitive journey throughout the hospital — with expansive natural daylight, access to courtyards and views to the bay, city and peninsula. The oncology department, for example, is strategically located on level eight, to fully optimise the 180-degree views of the bay and provide increased amenity for regularly attending patients and the staff that care for them. Image: Peter Clarke Key adjacencies between departments are intended through the vertical hospital design, with connection achieved through lifts and communication stairs, while the overall design responds to the adjacent parklands and local coastal context of the peninsula. Image: Peter Clarke The architectural design includes a massing, rusticated façade, palette of natural materials and landscaped interventions, with a sculptural verandah crowning the new main entrance, evoking the coastal setting, with the campus unified in the masterplan by linking the extensive green spaces. Image: Peter Clarke Intended to provide a connected health campus that embodies the spirit of Frankston and the Mornington Peninsula, redevelopment was designed to provide an additional 130 beds, 15 new operating theatres, new spaces for mental health and oncology services, a new helipad, as well as expanded women’s and children’s services. Image: Peter Clarke Image: Peter Clarke The public–private partnership is being delivered by a consortium comprising Capella Capital, Honeywell, Compass Group and Lendlease with Bates Smart and Architectus providing architecture, interior design and clinical health planning. Top image credit: Peter Clarke

All my friend wanted was to change a medical appointment for an ailing relative. He was prepared to deal with the classic interactive voice response system we all know and love — “for billing, press one; for appointments, press two” — knowing that with a few presses of “0” and saying the word “operator” at increasingly higher volumes he would get to a real person eventually. He was less prepared for AI’s new role in this interaction. For my friend, AI made his experience significantly worse. Since the chatbots were also programmed as AI agents, each time he tried to change the appointment, the bots decided instead to cancel it, setting him back further from where he started. So it wasn’t just a colossal waste of time; my friend was much worse off after having the AI system try to act on his behalf. After this experience, he was borderline nostalgic for the days of yelling “representative!” into the void. In time, I suspect more than half of healthcare interactions will start with AI. I’m confident AI will make those experiences remarkably more productive and efficient. In the vast majority of cases, it already does. When they aren’t, the result is more than wasted time. It’s distrust. Click image to enlarge. Image: Supplied Why the AI Failed After all, hearing what my friend went through, who could blame him for growing sceptical of AI’s place in healthcare? So what could have prevented this? My friend’s engineering background offered him insight into what was happening. The bots’ answers seemed constrained. That was probably implemented as a safety precaution, but it meant they couldn’t make sense of a complex situation. Maybe there are some edge cases that bots simply can’t address, at least for now. It’s necessary, therefore, to program a graceful off-ramp. My friend didn’t mind having to chat with a bot at the outset. The headache that followed would have been avoided had the bot, once it was out of its depth, been able to initiate a warm hand-off. Because as we all know, there’s no better tonic in those exasperating moments than the words: “Let me connect you with someone who can help.” Click image to enlarge. Image: Supplied The AI We Actually Need The goal shouldn’t be to create a system that simply mirrors our previous one: An AI-enabled warm transfer can do far more than merely redirect a call. The human agent should receive a complete background summary, such as what the individual needed, prior efforts made, and the full dialogue record. That frictionless shift transforms a frustrating obstacle into a reassuring showcase of AI-enabled healthcare. These agentic AI systems have their place, and again, they’re poised to do a world of good. Across all customer service inquiries, Gartner projects that by the end of the decade, 80 percent will be handled with AI, without the need for human intervention. That will be a win for both customers and providers, allowing simpler issues to be resolved faster and freeing provider resources to focus on the disabled, underserved, and complicated. Click image to enlarge. Image: Supplied People are also quickly warming to the idea of using chatbots in all sorts of health-related contexts. A recent U.S. Gallup poll found that more than half of respondents turned to AI for health information before doctor visits, which I believe is a great example of patients taking a proactive approach to their healthcare journey. But we need to remember that this growing confidence remains delicate. Every frustrating loop or misguided automated action does more than waste the user’s time, it undermines our progress. Should individuals lose faith during these early stages, they’ll likely revert to familiar phone trees or shun digital tools entirely. The real danger of poorly executed AI extends well beyond an improperly cancelled visit; it sabotages the broader willingness of patients to accept solutions that could genuinely transform modern healthcare. About the author As Vice President, Healthcare Practice for InterSystems, Dr Tim Ferris brings decades of experience directing large-scale healthcare technology transformations and leading major physician organisations to drive better patient outcomes and enterprise efficiency. Prior to joining InterSystems in February 2026, Dr Ferris served as President of Healthcare at Red Cell Partners, a technology incubator and investment firm. Previously, he was the National Director of Transformation at England’s National Health Service (NHS), as well as CEO and Chair of the Massachusetts General Physicians Organization and Senior Vice President for Population Health at Mass General Brigham. A recognised leader in health IT, Dr Ferris’s advisory roles include multiple committees at the U.S. National Academy of Medicine and the health policy advisory board at the Stanford University School of Medicine. Dr Ferris trained in medicine and public health at Harvard University and continues to lecture at Harvard Business School and the Harvard T.H. Chan School of Public Health. Top image: Supplied

Healthcare leaders are making decisions in an environment where pressure is no longer exceptional. Rising demand, workforce limitations, financial constraints and changing expectations are enduring features of the sector. These conditions require decisive leadership, but they can also influence how organisations define the challenges in front of them. Australia’s changing health needs provide important context. Australia’s population1 reached 27.6 million at 30 June 2025, while the proportion of Australians aged 65 and over has risen to 18 per cent1. At the same time, more than three in five Australians are living with at least one chronic condition. Chronic conditions2 also change the nature of demand. Their long-lasting and persistent effects can create more complex health needs, particularly when people are living with multiple conditions. For healthcare leaders, these trends reinforce a familiar reality: today’s decisions must address immediate priorities while preparing organisations for an environment that will continue to change. When the need to respond is constant, however, attention naturally gravitates towards what is most visible. Which services need attention? Where are priorities changing? What decisions need to be made now? These are necessary questions. Yet sustained pressure can also narrow the lens through which a challenge is viewed. When immediate requirements dominate attention, it becomes easier for the most urgent issue to define the wider conversation. The risk is not necessarily making the wrong decision. It is approaching an evolving challenge through a frame that may no longer capture its full dimensions. The way a problem is framed shapes what comes next Every organisational challenge arrives with an initial interpretation. Workforce pressures create one set of priorities; changing demographics create another; advances in technology introduce opportunities that may not have existed even a few years ago. Each is important. But the way a challenge is initially defined inevitably influences the choices that follow. That matters in healthcare because the environment itself is changing. Almost two in five Australians (38 per cent)3 are living with two or more chronic conditions, while Australians are living longer and the population is ageing. At the same time, AI, automation, data and digital health are expanding what organisations can consider possible. The questions facing healthcare leaders are therefore not static. They evolve alongside the communities being served, the workforce delivering care and the capabilities available to support them. This makes perspective increasingly important. An assumption that made sense five years ago may deserve to be tested again. A question framed around yesterday’s environment may produce a different set of choices from one designed for what lies ahead. This is not about challenging decisions simply for the sake of doing so. Nor is it about searching for complexity where none exists. It is about recognising that persistent challenges can become so familiar that the framing around them becomes familiar too. Periods of significant change provide an opportunity to look again. For healthcare executives, this can mean stepping above individual initiatives and considering whether the questions driving them remain sufficiently broad. Are we responding to the environment as it is today, or as it has traditionally been understood? Have new possibilities changed what we should be asking? Are there assumptions within familiar healthcare conversations that deserve a fresh perspective? Sometimes, reframing the question can reveal choices that were difficult to see from the original starting point. What if the capacity question deserves another look? Capacity is one of healthcare’s most familiar conversations. As Australia’s health needs continue to evolve, it will remain an important issue for leaders across the sector. But familiarity can itself be a reason to pause. What if the capacity question deserves to be looked at differently? The value of that question is not in pointing towards a predetermined answer. It is in creating room to examine a familiar leadership challenge from another perspective. Healthcare is entering a period in which demographic change, workforce realities and rapidly advancing technology will continue to reshape both needs and possibilities. Not every established assumption will become obsolete, but neither should every assumption remain unquestioned. For leaders navigating that transition, a different perspective may reveal a different way forward. A healthcare perspective from Nexon Nexon Asia Pacific works with health services, primary care, aged care, community care and health research organisations as they navigate the demands of today while preparing for the future of care. Its healthcare focus spans connected care, clinical continuity, digital resilience, workforce sustainability, cybersecurity, data and AI. In his Healthcare Leadership Insight, “Rethinking healthcare capacity: Finding more in what we already have”, Tony Mahony, Head of Healthcare & Emergency Services, National, Nexon Asia Pacific, takes that question further and offers a different perspective on one of healthcare’s enduring leadership challenges. Read the full Healthcare Leadership Insight: “Rethinking healthcare capacity: Finding more in what we already have.” 1. https://www.aihw.gov.au/reports/australias-health/profile-of-australias-population 2. https://www.aihw.gov.au/reports/australias-health/chronic-conditions 3. https://www.aihw.gov.au/news-media/media-releases/2026/july/latest-report-card-on-australia-s-health-reveals-areas-of-improvement-and-challenges

The 2025/26 Australian Health Practitioner Regulation Agency annual report has been released, revealing a record 13,171 completed notifications — more than any year since the National Registration and Accreditation Scheme commenced in 2010 — and, the regulator said, “an improved response to racism and discrimination and a continued focus on proactive, risk-based regulation”. Constituting the most serious matters, 295 practitioners were referred to a tribunal over concerns about their professional conduct, clinical performance and other issues. This marked a 53.6% increase on the previous year and was the most since 2013/14, Ahpra said, adding that effective harm prevention is a key theme of the National Scheme Strategy 2031, launched in March. “This year we completed more notifications than at any time in the National Scheme’s history, while reducing the number of long-running matters. That means earlier answers for patients and practitioners, and a regulatory system better able to focus on the risks that can cause the greatest harm,” Ahpra CEO Justin Untersteiner said. “Health care is changing. This means regulation must become more preventive, more transparent and better able to identify risk before harm occurs.” The report also reveals that the number of registered health practitioners rose by 4.1% to 999,105 in 2025/26. With Ahpra introducing new expedited pathways for international practitioners in a range of professions during the year, the latest figures show there were 70,832 first-time registrants, including more than 23,000 internationally qualified practitioners, with more than 185,000 students studying to become health practitioners. “As we close in on the significant milestone of one million registered health practitioners, we will continue to streamline our registration systems and processes and ensure a safe and sustainable workforce,” Untersteiner said. The number of practitioners who identify as Aboriginal and/or Torres Strait Islander was also found to have grown by 7.3% to 12,892, while Ahpra said that targeted recruitment campaigns saw the number of Board and committee members who identify as Aboriginal and/or Torres Strait Islander increase by 6 to 52. You can read the annual report 2025/26 at www.ahpra.gov.au/Publications/Annual-reports/Annual-report-2026.aspx. Image credit: iStock.com/skynesher

Being the legislatively prescribed tool used for home care assessments, the IAT’s algorithm makes automated decisions that determine the level of access to aged care services an older person can receive. With around 1.1 million or 85% of older persons accessing aged care services in Australia through the home support system, the Commonwealth Ombudsman said that “many concerns have been raised about the contracted assessment providers using the IAT and how the IAT algorithm works” since the SAS’s introduction. “The IAT and its associated decision-making framework do not merely have the potential to undermine public confidence: rather, a reasonable person would, in my view, lack confidence that the system is in fact fair and consistent. Currently, under the law, automated decisions made by the IAT’s algorithm cannot be overridden and changed, even if they are clinically inappropriate,” Commonwealth Ombudsman Iain Anderson said. Poor communication, substantial waiting times, slow review processes, insufficient assessors and assessors lacking appropriate training and qualifications were the concerns about the SAS workforce; while criticisms were that the IAT focuses on under-assessing care needs, diminishing the role of clinical expertise, the lack of algorithmic transparency and the inability to change automated decisions. Further, the Commonwealth Ombudsman noted that there is no publicly available information that explains how the IAT reaches its outcomes. “This is inconsistent with the intentions of the Robodebt Royal Commission recommendations about transparency of government automated decision-making,” the Commonwealth Ombudsman said. “In my view, the Department did not, and may still not, understand key components of the legal framework it created, nor did it understand what legal framework it was meant to create. This had serious consequences, including that up until the introduction of the legislation in October 2025, the Department had been incorrectly advising assessment providers and the public that automated IAT outcomes could be changed,” Anderson added. The Commonwealth Ombudsman found that the SAS assessment provider performance “has been falling short of KPIs, often significantly so”. The Commonwealth Ombudsman also said that the Department has taken a limited role in checking compliance with learning requirements, despite individual assessors inputting information into the IAT, and there are “no safeguards or mechanisms to protect the integrity of online training”. Amending the legislation to allow assessment decision-makers to override automated IAT decisions, a comprehensive review of the legislation related to the needs-assessment process, and a comprehensive review of the business rules underpinning the algorithm were among the 10 recommendations the Commonwealth Ombudsman made. That all changes be preceded by meaningful consultation with the public, and that the Australian National Audit Office consider a performance audit to assess whether the Department’s use of public resources was efficient, economical and ethical, was also recommended by the Commonwealth Ombudsman. The Department accepted the recommendations relevant to it, the Commonwealth Ombudsman said, with the full report — titled ‘Automation and oversight in Aged Care: Flaws in the design and operation of the Single Assessment System’ — available at www.ombudsman.gov.au/__data/assets/pdf_file/0019/331264/Automation-and-oversight-in-Aged-Care.pdf. Image credit: iStock.com/adamkaz