1. Start the encounterPatient conversation
1. Start the encounter
Open Vero and speak naturally with your patient. There is no need to dictate every section or follow a rigid script.
History and physical notes, built from the encounter
Turn the patient conversation into a structured H&P note without documenting every detail by hand. Vero captures the information discussed during the encounter and organizes it into a complete draft, ready for your review.
Complete the H&P without starting from a blank page
A comprehensive patient history can involve dozens of details across symptoms, medications, prior conditions, family history, social history, and examination findings.
Vero helps turn that information into clear, structured history and physical notes while the encounter is still fresh.
You review the draft, make any necessary changes, and approve the final note.
Capture the full encounter
Document the details discussed during the visit without typing through the conversation.
Keep every section organized
Place relevant information into the correct H&P sections automatically.
Review instead of rewriting
Start with a structured draft rather than rebuilding the encounter from memory.
What are history and physical notes?
History and physical notes, often called H&P notes, provide a comprehensive record of a patient’s current concern, relevant medical history, physical examination, clinical assessment, and care plan.
Clinicians commonly use H&P notes for new patient visits, hospital admissions, consultations, preoperative evaluations, and encounters that require a more complete clinical history.
Unlike a brief progress note, an H&P note establishes a broader clinical picture that can guide current and future care.
What is included in a history and physical note?
Vero can organize the encounter into the H&P structure selected by the clinician.
CC
Chief complaint
The primary reason for the patient’s visit, written clearly and concisely.
HPI
History of present illness
A structured account of the current concern, including onset, duration, severity, associated symptoms, and relevant context discussed during the visit.
PMH
Past medical history
Relevant diagnoses, previous conditions, hospitalizations, and other significant clinical history.
PSH
Past surgical history
Prior procedures and surgeries relevant to the patient’s current care.
Rx
Medications and allergies
Current medications, known allergies, and reported reactions discussed during the encounter.
Hx
Family and social history
Relevant family conditions, occupation, living situation, substance use, and other social factors.
ROS
Review of systems
Reported symptoms organized by the appropriate body systems.
PE
Physical examination
Documented examination findings organized into the clinician’s preferred format.
A/P
Assessment and plan
Clinical impressions, next steps, investigations, treatment considerations, referrals, and follow-up instructions.
From patient conversation to structured H&P
2. Vero builds the noteStructured H&P draft
2. Vero builds the note
Vero identifies relevant clinical details and organizes them into your selected history and physical note template.
3. Review and finalizeReview-ready note
3. Review and finalize
Check the draft, edit any details, and approve the note when it accurately reflects the encounter.
Example history and physical note
The following example shows how information from an encounter can be organized into a structured H&P draft.
New patient H&P
Structured draft · Ready to review
Chief complaint
Increasing shortness of breath for four days.
History of present illness
The patient reports four days of gradually worsening shortness of breath, primarily with exertion. They also describe a mild nonproductive cough and fatigue. They deny chest pain, fever, or recent travel.
Past medical history
History of hypertension and seasonal allergies. No previous history of asthma or chronic lung disease was reported.
Medications
Current medications reviewed with the patient.
Allergies
No known medication allergies reported.
Review of systems
Positive for shortness of breath, cough, and fatigue. Negative for chest pain, fever, chills, and lower-extremity swelling.
Physical examination
Patient is alert and able to speak in full sentences. Examination findings are organized by system based on the details documented by the clinician.
Assessment and plan
Clinical assessment, investigations, treatment decisions, patient instructions, and follow-up plan are documented.
History and physical notes that match your workflow
A fixed template rarely works for every clinician, specialty, or encounter.
Vero lets you create history and physical notes using the structure and level of detail that fit your practice.
- Use your existing H&P templates
- Choose concise or detailed documentation
- Change the order of individual sections
- Apply preferred clinical terminology
- Create templates for different visit types
- Edit every part of the generated note
Built for different H&P workflows
Create structured documentation for:
- New patient evaluations
- Hospital admissions
- Specialist consultations
- Preoperative assessments
- Annual comprehensive visits
- Complex patient encounters
- Transfer of care evaluations
- Specialty-specific H&P documentation
More than an H&P note generator
Vero can help carry information from the encounter into more of the clinical workflow.
Alongside history and physical notes, clinicians can prepare:
- SOAP notes
- Progress notes
- Consultation notes
- Procedure notes
- Discharge summaries
- Patient instructions
- Referral letters
- Follow-up tasks
- Coding suggestions
Frequently asked questions about history and physical notes
What are history and physical notes used for?
History and physical notes provide a comprehensive clinical picture of the patient. They are commonly used for admissions, consultations, new patient encounters, preoperative evaluations, and other visits requiring detailed documentation.
What should a history and physical note include?
A typical H&P note includes the chief complaint, history of present illness, past medical and surgical history, medications, allergies, family history, social history, review of systems, physical examination, assessment, and plan.
What is the difference between an H&P note and a progress note?
An H&P note provides a broad initial assessment of the patient and their clinical history. A progress note usually documents changes, findings, and decisions during a subsequent or follow-up encounter.
Can Vero create history and physical notes from a patient conversation?
Vero can use the clinical details discussed during the encounter to prepare a structured H&P draft.
Can I use my own H&P template?
Yes. You can adapt the structure, section order, terminology, and level of detail to match your documentation preferences.
Can I edit the generated note?
Yes. Every generated H&P note is editable.
Create history and physical notes without rebuilding the encounter
Stay focused on the patient while Vero prepares the first draft. Review the note, make it yours, and finish your documentation sooner.