What is the History of Present Illness (HPI)?

The history of present illness (HPI) is a set of interview questions that a healthcare provider will ask a patient about their chief complaint in order to assist with diagnosing the patient. HPI questions are designed to give a clinician an accurate history of the patient’s concern. In many cases, a diagnosis can be made from an analysis of the HPI, a review of systems (ROS), and a physical examination.

What Questions Are Asked in an HPI?

While there are many variations on the HPI format, most include a common set of questions. A popular example is summarized by the acronym OLD CARTS:

Onset
Location
Duration
Characteristics
Aggravating factors
Relieving factors
Treatments tried
Symptoms associated

The Centers for Medicare & Medicaid Services (CMS) has defined criteria for a reimbursable HPI. Here is CMS’s list and how each entry relates to the OLD CARTS method:

Timing Onset
Location
Duration
Quality (Characteristics)
Severity (Characteristics)
Content (Onset)
Modifying factors (Aggravating and Relieving factors)
Associated signs and symptoms (Symptoms associated)

History of Present Illness in Today’s Healthcare

Since the combination of the HPI and a physical exam has proven useful in diagnosing the cause of patient complaints, the questions are still in wide use today.

Many health IT systems recognize the usefulness of the HPI and provide some sort of digital tool for administering and recording the questions.

How TempDev Can Help With HPI

TempDev’s team of NextGen consultants, developers, and trainers support your needs whether you’re looking to implement, switch, or even upgrade your current EHR system. From dashboards and revenue cycle consulting to automation and workflow redesign, TempDev offers the tools you need to make the most of your NextGen EHR system, with top tips and tricks that will ensure your success now and in the future.

With TempDev’s NextGen dashboards, templates, and reports, you can better support your patients’ needs. Our team is here to help you design, organize, and implement the whole system and offer tips and guidance based on industry best practices.