What Is HPI in Medical Terms? How to Write One in 2025

Writing clinical notes can feel like a never-ending task, especially when you're moving from one patient to the next. Most providers know how quickly documentation can pile up if it’s not handled efficiently.

For example, if you're writing a SOAP note for a patient visit, it can be easy to get behind while writing the HPI or assessment.

An HPI, or History of Present Illness, is the section of a medical note that explains the patient’s current condition in their own words and supports clinical decision-making.

In this article, we'll outline what an HPI is in medical terms and provide some tips on how you can write it in your SOAP notes in 2025. Let's dive in!

What Is HPI in Medical Terms? Meaning and Definition

Definition: In medical terms, HPI stands for history of present illness. It’s the part of the medical note where you describe the patient’s current condition based on what they tell you during the visit.

Meaning: The HPI gives context to the chief complaint. It explains when the symptoms started, how they’ve changed, and what makes them better or worse. This section is meant to tell the story of the illness from the patient’s point of view.

In practice, the HPI helps guide the rest of the visit. It shapes your assessment and plan, and it’s important for coding, billing, and documentation. A well-written HPI can also help justify medical necessity and narrow down possible diagnoses.

HPI Medical Abbreviation

HPI is the medical abbreviation for history of present illness. It's used in SOAP notes and other clinical documentation formats

This medical abbreviation helps describe the onset, location, duration, characteristics, aggravating/relieving factors, timing, and severity of the chief complaint.

What Should an HPI Do?

An HPI note should clearly explain the patient's current condition while staying focused on the chief complaint. It also plays a key role in SOAP notes, differential diagnosis, and documenting medical necessity.

Here are a few things that an HPI should do:

• Tell the patient’s story - Describe how the symptoms started, how they’ve changed, and what the patient is currently experiencing.

• Support differential diagnosis - Give enough detail to help narrow down possible conditions.

• Fit into SOAP notes - The HPI belongs in the Subjective section and sets the stage for the rest of the note.

• Justify medical necessity - Include context that supports why tests, treatments, or referrals are needed.

• Stay clear and compliant - Keep it focused, readable, and aligned with documentation standards.

A well-written HPI makes the rest of the note easier to complete and helps ensure you're covered from both a clinical and billing perspective.

How to Write an HPI

A good HPI note should be structured, clear, and focused on the patient’s current problem. Each part of the note should help build a timeline and support your clinical reasoning.

Here's how to write an HPI:

Start With the Chief Complaint

Begin by stating why the patient came in, using their own words when possible. This anchors the rest of the note and keeps it focused.

If the patient has multiple concerns, pick the one that’s most relevant to the visit.

Use a Chronological Format

Describe the symptom timeline from the onset to the present. Note any changes, worsening or improvement, and key events along the way.

A clear timeline helps other providers understand the full picture quickly when they are reviewing the notes for the patient.

Include Relevant Details Only

Focus on what directly relates to the chief complaint. Avoid filling the note with unrelated past medical history or excessive review of systems. Keep it sharp and to the point.

Cover OLDCARTS Elements

OLDCARTS is a useful tool for organizing symptom information in your HPI. You don’t need to include every element, but covering the most relevant ones can help make your note more complete.

• Onset - When did the symptoms start?

• Location - Where is the symptom located?

• Duration - How long has it been going on?

• Characteristics - What does it feel like?

• Aggravating factors - What makes it worse?

• Relieving factors - What makes it better?

• Timing - Is it constant or intermittent?

• Severity - How bad is it on a scale of 1–10?

Keep It Objective and Precise

Stick to what the patient reports and avoid guessing. Use clear language and avoid vague terms like “a bit” or “kinda.”

The goal is to create a note that’s easy to interpret later.

Align With SOAP Structure

Remember that the HPI is part of the Subjective section. It should naturally lead into your objective findings, assessment, and plan.

A well-written HPI sets up the rest of the SOAP note for success and helps you later on while writing your differential diagnosis.

What Is the Format for HPI Notes? What Do I Include?

HPI notes should follow a structured format to keep them consistent, readable, and complete. Here’s a format you can use, along with what to include in each section:

This format helps ensure the HPI note flows logically and contains everything needed for a solid clinical picture.

Where Does HPI Go in SOAP Notes?

The HPI is part of the Subjective section in SOAP documentation.

It sits immediately after the chief complaint and sets the stage for the provider's assessment and plan. Keep it focused on the reason for the visit.

How to Write HPIs and SOAP Notes With AI

Seeing patients is more important than taking notes, but for healthcare professionals, it can often be flipped in terms of which one gets more of your time. It shouldn't have to be that way.

Instead, use AI Blaze to streamline documentation and write HPIs and SOAP notes with AI right in your EMR, which helps you reclaim your time and focus on patients.

AI Blaze is your personal AI assistant that helps you proofread and review your notes, generate notes in any format, summarize data, and much more.

AI Blaze works on any website or EMR and helps you streamline your documentation, no integration required.

Features

• Generate HPIs and SOAP notes with AI - Quickly generate a history of present illness and SOAP note for any patient visit.

• Polish/reformat your notes - AI Blaze can take your rough notes and quickly rewrite them to fit guidelines & requirements and help make sure they are compliant.

• Summarize notes & text on any website - Summarize your notes or any text (including images) using AI that works anywhere you do.

• AI Blaze works in any EMR (no integration required)! - Use AI Blaze to save time right where you work without the hassle of integration.

HPI Template & Example

A clear, structured HPI makes it easier to understand the patient's condition and document medical necessity. You can use the same general structure across specialties and adjust the details as needed.

Here's a universal HPI template and an example you can use to help with writing your own HPI:

Universal HPI Template

Use this as a baseline and customize it for each patient.

HPI Example

This example shows how the template might look when filled out.

Final Thoughts on Writing Better HPI Notes

HPI notes are a critical part of patient documentation and play a major role in clinical decision-making, billing, and compliance. In 2025, providers need a fast, consistent way to capture the story of the patient’s illness without losing clarity or accuracy.

Stick to a clear format, focus on relevant details, and keep the note aligned with the SOAP structure. Whether you’re documenting manually or using AI to speed things up, a well-written HPI saves time and improves the quality of care.

To recap, use AI Blaze to write HPIs and SOAP notes with AI and reclaim your time so that you can get back to your patients.