This PhD (Innovation) portfolio presents the New England Inter-Connected Healthcare Ecosystem (NICHE) project and the development of its two core deliverables: a conceptual model of digitally enabled healthcare practice and an associated implementation strategy. Developed in response to the persistent challenges in healthcare access in regional, rural, and remote (RRR) communities in Australia, this work is grounded in the specific context of the New England region of New South Wales (NSW), where workforce shortages, service fragmentation, and geographic isolation have contributed to significant health disparities.
Two central research questions guided the project:
1. How can the potential for a digitally enabled, integrated, and interconnected approach to healthcare practice, responsive to the healthcare needs of RRR communities, be conveyed via a conceptual model for replication locally and potentially at scale? And
2. How can change management theories, academic research findings, and ongoing stakeholder insights inform the model and its implementation approach to support the transition from concept to practice?
Adopting an interpretivist constructivist paradigm, the research informing the NICHE project employed qualitative methods, drawing on action research and framework analysis, to iteratively develop and refine the NICHE model and its implementation approach. Insights were derived from three primary data sources: health policy and strategy documents, peer-reviewed academic literature, and reflective notes captured during meetings, discussions, and industry events. Although formal interviews were not conducted, the reflective notes incorporated both observational insights and active engagement, including delivering presentations, participating in informal discussions, and reflecting on sector feedback. These varied encounters provided rich, context-specific perspectives on local priorities and sector dynamics, which helped shape the design and direction of the work.
Project outputs include a flexible, community-responsive conceptual model of healthcare practice, a recommended list of digital tools and applications proposed for inclusion in a supporting technology toolkit, and an implementation approach comprising an overarching implementation strategy and a flexible roadmap for adaptation across sites. Although developed with the New England region in mind, the deliverables are designed to be responsive to the specific needs of individual communities. Their design aligns with national, NSW Health, and local digital health policies and directions, positioning NICHE as a scalable and context-sensitive response to Australia’s rural health crisis.
Addressing entrenched inequities in RRR healthcare access requires grounded, practical approaches that consider local complexity and systemic challenges. NICHE responds to this need by offering a conceptual model of care that aligns with policy directions, engages with sector realities, and incorporates the lived experiences of RRR communities. Its development brings research, policy, and practice into closer dialogue, offering a thoughtful foundation for change that may be adapted and applied more broadly.