Past medical history

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Not to be confused with Medical history or History of medicine.
"Past history" redirects here. It is not to be confused with History of presenting complaint (history of the present illness).
"PFSH" redirects here. For the airport in Alaska with that ICAO code, see Shaktoolik Airport.

In a medical encounter, a past medical history (abbreviated PMH),[1] is the total sum of a patient's health status prior to the presenting problem.

Questions to include[edit]

Different sources include different questions to be asked while conducting a PMH, but in general, they include the following:

Acronyms[edit]

Several acronyms have been developed to categorize the appropriate questions to include:

  • "MMASH", for Medical Illnesses, Medications, Allergies, Surgeries, Hospitalizations.[3]
  • "PAM HUGS FOSS",[4] for
    • Previous presence of the symptom (same chief complaint)
    • Allergies (drugs, foods, chemicals, dust, etc.)
    • Medicines (any drugs the patient used)
    • Hospitalization for any illness in the past
    • Urinary changes (especially if diabetic or elderly)
    • Gastrointestinal complaints (diet changes, bowel movements, etc.)
    • Sleep pattern (waking up/going to sleep, etc.)
    • Family history (similar chief complaints/serious illness)
    • OB/GYN history (LMP, abortions, etc.)
    • Sexual habits (active/preferences/STD, etc.)
    • Social life (job/house/smoking/alcohol, etc.)

In prehospital medicine, namely EMS, the acronym SAMPLE is used.

  • Signs/Symptoms
  • Allergies
  • Medicine (Prescriptions)
  • Past Pertinent History
  • Last bowel movement/oral intake
  • Events leading to the current complaint

Medicare definitions[edit]

The Centers for Medicare and Medicaid Services[5] has published criteria for what constitutes a reimbursable PMH. A PMH is considered one of three elements of the "Past, Family, and Social History" (abbreviated as PFSH):[6]

  • Past medical history: "the patient's past experiences with illnesses, operations, injuries and treatments";
  • Family history: "a review of medical events in the patient's family, including diseases which may be hereditary or place the patient at risk";
  • Social history: "an age-appropriate review of past and current activities".

A pertinent PFSH consists of at least one of the three components; a full PFSH consists of two or three components for an established patient, or all three components for a new patient visit.[7]

CMS required history elements[8]
Type of history CC HPI ROS Past, family, and/or social
Problem focused Required Brief N/A N/A
Expanded problem focused Required Brief Problem pertinent N/A
Detailed Required Extended Extended Pertinent
Comprehensive Required Extended Complete Complete

See also[edit]

References[edit]

  1. ^ Swartz, Mark (2002). Textbook of Physical Diagnosis: History and Examination. Philadelphia: Saunders. pp. 19–23. ISBN 1-4160-2405-0. 
  2. ^ http://www.sciencedaily.com/releases/2004/09/040907083159.htm Science News: Enlarged Tonsils, Adenoids And Allergies May Affect A Child's Bite, Facial Appearance And/Or Behavior
  3. ^ Useful Acronyms for Facilitators and Students
  4. ^ HPI (history of present illness)
  5. ^ http://www.cms.hhs.gov/
  6. ^ Evaluation and Management Coding and Electronic Health Records
  7. ^ Evaluation and Management Coding and Electronic Health Records
  8. ^ "www.cms.gov". Retrieved 2011-02-27. 

External links[edit]