Sociotechnical design of an electronic tool for managing transient ischemic attack in the emergency department.

This paper describes the adoption of a prototype electronic decision support tool for managing transient ischemic attack (TIA) in the Emergency Department (ED) of a health region in Canada. A clinician-driven sociotechnical design approach is used to develop, test and implement the prototype with the aim to improve TIA management in the ED. In this study, we worked closely with ED staff to: identify issues and needs in TIA management; build/test/refine prototype versions of the electronic TIA decision support tool; and explore strategies to implement the tool for routine use in the ED. A blood protein biomarker test under development will also be incorporated as part of this tool in a subsequent phase. Thus far the prototype has demonstrated the potential to improve triage, risk stratification, and disposition decisions based on historical TIA and mimic cases. A prospective multi-site clinical utility study is planned for spring of 2016.