History of the present illness

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In a medical encounter, a history of the present illness (HPI) (termed history of presenting complaint (HPC) in the UK) refers to a detailed interview prompted by the chief complaint or presenting symptom (for example, pain).

Contents

[edit] Questions to include

Different sources include different questions to be asked while conducting an HPI, but in general they include the following:

  • onset
  • location and radiation
  • severity and character/quality
  • duration and timing
  • precipitating and palliating factors
  • progression

[edit] Acronyms

Several acronyms have been developed to categorize the appropriate questions to include:

[edit] Medicare definitions

The Centers for Medicare and Medicaid Services has published criteria for what constitutes a reimbursable HPI. A "brief HPI" constitutes one to three of the following elements:

  • location
  • quality
  • severity
  • duration
  • timing
  • context
  • modifying factors
  • associated signs & symptoms

A "extended HPI" includes four or more of these elements.[7][8]

[edit] See also

[edit] References

  • Adler H. "The history of the present illness as treatment: who's listening, and why does it matter?". J Am Board Fam Pract 10 (1): 28–35. PMID 9018660. 

[edit] Footnotes

  1. ^ Medical Assessment
  2. ^ Learning To Perform a Medical Assessment – Part 1: Quick Medical Assessment
  3. ^ WEMSI - Assessment by PQRST
  4. ^ Department of Medicine Home Page
  5. ^ Dartmouth Medicine Magazine :: Student Notebook
  6. ^ HPI (history of present illness)
  7. ^ Evaluation and Management Coding and Electronic Health Records
  8. ^ http://www.usc.edu/health/uscp/compliance/tm6.html#6

[edit] External links

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