Past medical history

From Wikipedia, the free encyclopedia
Jump to: navigation, search

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 complains (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]