A Flag Proposition For Every Electronic Health Record: History of Trauma

A Proposition For Every Electronic Health Record: History of Trauma Flag

Do you want to minimize harm during a physician’s visit? Don’t make your patient repeatedly recount trauma.

Reading the Book “The Body Keeps the Score” allowed me to articulate and understand much more about how the traumatic events of my childhood have shaped my perceptions of the world. The author applies his extensive knowledge of a variety of types of PTSD, and discusses many scientific discoveries about trauma in addition to different treatments. While reading this book, it struck me that electronic health records should have a History of Trauma flag that physicians utilize in order to minimize patient harm.

As a victim of chronic childhood abuse, there have been physical in addition to mental and emotional impacts to me. Having my physician understand this trauma is key to them being able to treat me, but having to repeatedly tell the story of what happened is causing harm. An electronic health record flag to record this history of trauma and re-alert the physician before talking to me would go a long way to ensuring that I don’t have to re-live the trauma more than necessary.

One of the primary points of “The Body Keeps the Score” is that how trauma is processed is determined by an individual, so no individual will process trauma the same. In fact, van der Kolk recounts at least one tale in which two people were in the same car accident, but had contrasting reactions to the trauma. The thing that was the same was the fact that “When something reminds traumatized people of the past, their right brain reacts as if the traumatic event were happening in the present.”

Because the type of violence that I experienced was extended over an amount of time, it affected many aspects of my health. It has also made every visit to the doctor an instance of re-traumatization. Given the recognition that repeated exposure can cause true harm, it’s time for healthcare IT to apply their tools to harm reduction. Having a flag in the medical record that would alert the physician to some details of the trauma would go a long way towards supporting them in giving their patient trauma-informed care.