The HPI medical abbreviation stands for history of present illness, the section of a medical note that lays out, step by step, how the current problem began and developed. It follows the chief complaint and comes before the past history, medicines and exam.
A good HPI reads like a short, ordered account: when the problem started, what it feels like, what changes it, and what else came with it. Doctors, nurse practitioners, physician assistants and scribes write HPIs every day, and students practice them early in training. This guide covers the parts of an HPI, the memory aids used to gather them, a worked example and common pitfalls.
At a glance
Where the HPI medical abbreviation fits in a note
The HPI medical abbreviation meaning is the same in every specialty, and this medical acronym is spoken as three separate letters. Most full notes follow a standard order. The HPI is the subjective heart of it, written mostly from what the patient or family says.
| Section | What it covers |
|---|---|
| CC | A brief phrase naming why the person came |
| HPI | The detailed story of that problem |
| PMH, PSH, meds, allergies | Past conditions, surgeries, medicines and allergies |
| Social and family history | Habits, home life and conditions that run in the family |
| ROS | A system by system symptom checklist |
| Exam, then assessment and plan | What was found, what it likely is, and what happens next |
What a complete HPI includes
Documentation guidelines and teaching programs describe the same core elements of the present illness:
- Location: where the problem is
- Quality: what it feels like, such as sharp, dull or burning
- Severity: how bad it is, often on a 0 to 10 scale
- Duration: how long it has been going on
- Timing: constant, coming and going, worse at certain times
- Context: what the person was doing when it began
- Modifying factors: what makes it better or worse
- Associated signs and symptoms: what else is happening
Students often use memory aids to cover these points. OLDCARTS (onset, location, duration, character, aggravating factors, relieving factors, timing, severity) and OPQRST (onset, provocation, quality, radiation, severity, time) are two common ones.
HPI medical abbreviation example
Sample HPI: "45 yo M presents with 2 days of RLQ abdominal pain. Pain began around the navel and moved to the right lower abdomen. Describes it as sharp and constant, 7/10, worse with walking and coughing, no relief with acetaminophen. Associated nausea and poor appetite, one episode of vomiting. Denies diarrhea, urinary symptoms or fever at home."
In a few lines this covers location, quality, severity, duration, timing, modifying factors and associated symptoms. It also includes pertinent negatives, the symptoms the patient does not have, which help the reader rule things in or out.
Tips for writing a clear HPI
Keep events in time order, starting from when the person last felt well. Use the patient's own words for key descriptions, in quotation marks if helpful. Include treatments already tried and how they worked. Leave exam findings and test results for their own sections of the SOAP note or H&P, since the HPI is the history. Avoid copying an old HPI forward without updating it, a common source of errors in electronic records.
For scribes and coding trainees, the number and detail of HPI elements can matter for visit documentation, so completeness has practical value as well as clinical value.
Reading an HPI in your own record
When patients read visit notes through a portal, the HPI is usually the easiest section to follow because it retells their own account. If something important is missing or recorded wrongly, such as the start date or a medicine you tried, you can let your care team know. Many other note abbreviations are explained in the chart notes abbreviations section.
This page describes how a note section is built. Questions about the content of your own visit notes are best raised with the clinician or office that wrote them.
Frequently asked questions
What does HPI stand for in medical terms?
HPI stands for history of present illness. It is the note section devoted to the current problem, told in detail.
What is the difference between CC and HPI?
CC is the reason for the visit boiled down to a phrase, often in the patient's own words. The HPI expands that complaint into a full, ordered story.
What does OLDCARTS stand for?
OLDCARTS stands for onset, location, duration, character, aggravating factors, relieving factors, timing and severity. It is a memory aid for gathering a complete HPI.
Who writes the HPI?
The clinician seeing the patient usually writes it, sometimes with help from a scribe. Nurses also record a focused history when a patient arrives.