Write history of present illness (HPI)
AI asks about chief complaint and symptom details, then generates a complete HPI paragraph ready to paste into your note.
Write history of present illness (HPI)
River's HPI Writer creates complete, well-organized history of present illness paragraphs from patient symptom information. You provide chief complaint and details about onset, duration, character, severity, modifying factors, and associated symptoms, and the AI writes a comprehensive HPI paragraph using proper medical terminology and logical flow. The paragraph includes all relevant elements in narrative format ready for your medical record. Perfect for medical students learning documentation, residents managing high patient volumes, or any clinician needing efficient HPI documentation.
Unlike brief, incomplete symptom descriptions, this AI structures clinical information into proper HPI format. The tool ensures you capture all critical elements (OLDCARTS: Onset, Location, Duration, Character, Aggravating/Alleviating factors, Radiation, Timing, Severity), includes pertinent positives and negatives, and presents information in logical narrative that tells the story of patient's illness. When HPIs are complete and well-organized, they facilitate clinical reasoning and support medical decision-making.
This tool is perfect for medical students learning proper HPI documentation, residents documenting efficiently during busy shifts, attending physicians ensuring complete histories, or any clinician who wants well-structured HPI paragraphs quickly. If your HPIs lack detail or organization, this creates professional clinical narratives. Use it for any patient encounter requiring HPI documentation.
What Makes HPIs Complete
Complete HPIs tell the story of patient's illness using the OLDCARTS mnemonic: Onset (when did it start?), Location (where?), Duration (how long?), Character (what's it like?), Aggravating/Alleviating factors (what makes it better or worse?), Radiation (does it spread?), Timing (constant or intermittent?), Severity (how bad?). Weak HPIs state only 'patient has chest pain' without details. Strong HPIs answer all relevant questions: 'Patient presents with substernal chest pain that began 2 hours ago, described as pressure-like, 7/10 severity, radiating to left arm, worsened by exertion, partially relieved by rest, constant since onset, associated with diaphoresis and nausea.'
Good HPIs also include relevant history (has this happened before?), prior treatments and response (what has patient tried?), and pertinent negatives (what symptoms are absent?). These elements help narrow differential diagnosis. For example, in chest pain, noting absence of fever, cough, or pleuritic nature helps rule out certain causes. Review of relevant medical history (prior cardiac disease, risk factors) provides context. Document patient's own words when helpful ('It feels like an elephant sitting on my chest'), but translate vague descriptions into specific clinical terms.
HPI should flow as coherent narrative, not bulleted list. Read your HPI and ask: does this tell clear story of illness? Would another provider reading this understand what happened? Can I formulate reasonable differential based on this history? If yes, your HPI is complete. If you're missing key details or story doesn't make sense, gather more information. The HPI is foundation for clinical reasoning, so invest time in getting it right. Complete histories lead to accurate diagnoses.
What You Get
Complete HPI paragraph with all relevant elements
OLDCARTS components included (onset, character, severity, etc.)
Pertinent positives and negatives
Proper medical terminology and narrative flow
Ready to paste into medical record
Professional clinical documentation
How It Works
- 1Provide symptom detailsAI asks about chief complaint and all HPI elements
- 2AI writes HPIGenerates complete HPI paragraph in 2-3 minutes
- 3Review and pasteVerify accuracy and copy into your documentation
- 4Complete your noteContinue with ROS, exam, and assessment/plan
Frequently Asked Questions
How detailed should the HPI be?
Include enough detail to support clinical reasoning and medical decision-making. For complex cases or ED presentations, more detail helps. For routine follow-up visits, briefer HPI may suffice. Include all OLDCARTS elements relevant to chief complaint, prior treatments tried, and pertinent negatives that narrow differential. Generally, 3-5 sentence HPI for straightforward issues, longer for complex presentations. Quality matters more than length.
What if patient has multiple chief complaints?
Create separate HPI for each distinct problem or address related complaints together if they're connected. For multiple unrelated issues, organize with headings or separate paragraphs. If one issue is clearly primary (reason for visit), start with that and address other issues more briefly. For comprehensive exams with multiple chronic conditions, you might document each problem separately in assessment and plan rather than lumping all into one HPI.
Should I include exact patient quotes?
Use direct quotes sparingly when they capture something important that paraphrasing would lose. Patient describing pain as 'like an elephant on my chest' or 'worst headache of my life' provides useful clinical information. However, translate vague descriptions into clinical terms. Patient saying 'I feel bad' becomes 'patient reports fatigue, poor appetite, and low mood.' Balance between capturing patient's voice and using precise medical language.
How do I document review of old records or outside information?
Include within HPI when relevant: 'Patient reports similar episode 2 years ago with ED visit, records reviewed showing...' or 'Per outside hospital records, patient was diagnosed with...' This shows you've gathered information beyond patient interview and considered relevant history. Documenting your information sources (patient report, old records, family member) is good practice, especially when there are discrepancies.
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