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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).
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".12 Alternatively, "PQRST".34 See also Opqrst.
- "CLEARAST"5
- "LIQOR AAA"6
- "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.78
See also
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.
Footnotes
- ^ Medical Assessment
- ^ Learning To Perform a Medical Assessment – Part 1: Quick Medical Assessment
- ^ WEMSI - Assessment by PQRST
- ^ Department of Medicine Home Page
- ^ Dartmouth Medicine Magazine :: Student Notebook
- ^ HPI (history of present illness)
- ^ Evaluation and Management Coding and Electronic Health Records
- ^ http://www.usc.edu/health/uscp/compliance/tm6.html#6
External links
