History of the present illness
- History of the present illness
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).
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
Acronyms
Several acronyms have been developed to categorize the appropriate questions to include:
* "OPQRST". [ [http://hopperinstitute.com/emt_medical.html Medical Assessment ] ] [ [http://www.alpharubicon.com/med/medaccesshaumanao.htm Learning To Perform a Medical Assessment – Part 1: Quick Medical Assessment ] ] Alternatively, "PQRST". [ [http://www.wemsi.org/pqrst.html WEMSI - Assessment by PQRST ] ] [ [http://www.usask.ca/medicine/medicine/clsc.htm Department of Medicine Home Page ] ] See also Opqrst.
* "CLEARAST" [ [http://dartmed.dartmouth.edu/spring06/html/student_notebook.php Dartmouth Medicine Magazine :: Student Notebook ] ]
* "LIQOR AAA" [ [http://www.aippg.net/forum/viewtopic.php?p=71106 HPI (history of present illness) ] ]
* "FAR COLDER"
* "OLD CART"
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. [ [http://www.emrconsultant.com/emr_EMcoding.php Evaluation and Management Coding and Electronic Health Records ] ] [http://www.usc.edu/health/uscp/compliance/tm6.html#6]
ee also
* medical record
* medical history
* pain scale
References
*
Footnotes
External links
* [http://www.usc.edu/health/uscp/compliance/tm6.html#6 Overview at usc.edu]
* [http://medicine.ucsd.edu/clinicalmed/history.htm Overview at medicine.ucsd.edu]
* [http://www.nur.utexas.edu/fachome/eabel/poster/sld030.htm Overview at nur.utexas.edu]
*
* [http://medinfo.ufl.edu/year1/bcs96/interv/hpians.html Overview at medinfo.ufl.edu]
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