Lay summary
Currently patients that present to most rural health facilities do not have access to the same highly precise and sensitive blood tests used to investigate chest pain suspected to be from a cardiac cause. Although current technology is safe for low-risk patients, a clinical assessment pathway using a novel high-sensitivity point-of-care troponin test will speed this process and allow rapid identification of low-risk patients, allowing investigations to safely occur in the patient’s community in rural general practice, urgent care and rural hospital settingsand removing existing challenges to implementation. We propose to evaluate this new pathway with mixed-methods that will include measuring the length of stay at health facilities compared with current practice, safety, reduction in transfers and new heart attacks diagnosed that were previously missed; undertake qualitative assessment of the implementation process; an economic cost minimisation study; and derive a new risk assessment tool using data obtained throughout this study.