# Dispositions — Health Disease History Calls

Use **one primary disposition** at the end of every contact. These codes are for **disease history only**. Do not use BMI, height/weight, policy, sale, or payment outcomes.

Match the call to `communication.md`. If the customer objected, follow `objection.md`. If they asked why a disease group is on the list, use `faq.md`.

---

## How to choose

1. Was there a **possible emergency**?  
   - Stop. Use `HX_EMERGENCY_STOP`. Do not finish the disease list.
2. Did the customer **consent** to record health details?  
   - No → `HX_CONSENT_DECLINED`.
3. Did you finish the **disease groups** (yes / no / skip for each)?  
   - Yes, with follow-ups on every “yes” → a complete code.  
   - Some groups left, or “yes” without timing/treatment → partial.
4. Did they **refuse all conditions** after consent?  
   - `HX_DECLINED`.
5. Did they only want **explanations**, no history stored?  
   - `HX_EDUCATION_ONLY`.

If two codes could apply, pick the **most important health outcome** (emergency first, then complete vs declined vs callback).

---

## Disposition list

| Code | Name | When to use |
| --- | --- | --- |
| `HX_NONE_REPORTED` | History complete — no diseases reported | All groups asked. Customer reported no diagnoses. Confirmed back. |
| `HX_COMPLETE` | History complete — one or more diseases | All groups asked. Each “yes” has condition name plus timing and/or treatment status as the customer could give. |
| `HX_COMPLETE_MULTI` | History complete — several disease groups | Two or more groups had a “yes” (for example diabetes and heart). Follow-ups done. |
| `HX_CANCER` | Cancer history captured | Primary finding is cancer (type/site, timing, treatment status). Other groups done or clearly none. |
| `HX_DIABETES` | Diabetes history captured | Primary finding is diabetes (type if known, insulin, diagnosis timing, complications if any). |
| `HX_HEART` | Heart / circulatory history captured | Primary finding is heart or circulation (including stroke/TIA, stent, CHF, BP if that was the main item). |
| `HX_LUNG` | Lung history captured | Primary finding is asthma, COPD, oxygen, sleep apnea, or TB. |
| `HX_KIDNEY` | Kidney history captured | Primary finding is dialysis, failure/insufficiency, polycystic disease, or nephrectomy. |
| `HX_LIVER` | Liver history captured | Primary finding is hepatitis, cirrhosis, or liver failure. |
| `HX_DIGESTIVE` | Digestive history captured | Primary finding is Crohn’s, colitis, ulcer, diverticulitis, or GI/bariatric surgery. |
| `HX_NEURO_IMMUNE` | Neurological / immune history captured | Primary finding is seizures, MS, Parkinson’s, neuropathy, lupus, cerebral palsy, or similar. |
| `HX_JOINT_MUSCLE` | Joint / muscle history captured | Primary finding is arthritis, dystrophy, paralysis, or related. |
| `HX_MENTAL` | Mental / nervous history captured | Primary finding is anxiety, depression, bipolar, PTSD, dementia, or intellectual disability. |
| `HX_DISABILITY` | Disability (medical reason) captured | Under 65; medical reason for disability recorded. Not income or benefits. |
| `HX_OTHER` | Other health captured | Primary finding is substance use disorder, amputation, blindness, home health/hospice, hospital stay, or wheelchair. |
| `HX_PARTIAL` | Incomplete disease list | Some groups not asked, or a “yes” without enough detail and no callback set. |
| `HX_SKIPPED_SENSITIVE` | Complete except skipped groups | Customer skipped mental health, substance use, or another group; remaining history finished. |
| `HX_UNSURE` | Customer unsure of diagnoses | Could not confirm names; noted to verify with clinician. Little or no confirmed disease list. |
| `HX_EDUCATION_ONLY` | FAQ only — no history stored | Explained disease groups; customer did not want conditions recorded. |
| `HX_DECLINED` | Declined to share disease history | Refused conditions after objection handling. Do not guess. |
| `HX_CONSENT_DECLINED` | Declined consent | Did not agree to record health details. Stop. |
| `HX_CALLBACK` | Callback to finish history | Willing but needs records, privacy, or more time. Appointment set if possible. |
| `HX_WRONG_PARTY` | Not the person whose history is needed | Wrong contact. |
| `HX_LANGUAGE_BARRIER` | Could not complete — language | Arrange a qualified interpreter. Do not guess disease names. |
| `HX_EMERGENCY_STOP` | Stopped — possible urgent symptoms | Chest pain, severe breathing trouble, fainting, sudden weakness, stroke-like symptoms. Directed to urgent/emergency care. |
| `HX_DISTRESSED` | Stopped — customer upset | Too distressed to continue. Offer to end or callback. |
| `HX_NO_CONTACT` | No answer / voicemail / disconnected | No live health conversation. Do not leave medical advice on voicemail. |
| `HX_UPDATE` | Existing disease history updated | New diagnosis, treatment change, or correction to a prior list. |

When several diseases apply, use `HX_COMPLETE_MULTI` as the primary code and list each condition in notes. Use a single-disease code only when that group is clearly the main history.

---

## Required notes (health only)

Write facts another agent can use. Use the customer’s words.

**Include when known**

- Disease group and condition name
- Year or approximate timing of diagnosis or last event
- Current treatment: medication (if shared), insulin, dialysis, oxygen, device, surgery year
- Still followed by a specialist? yes / no / unknown
- Groups skipped, declined, or marked unsure
- Who answered (customer vs caregiver, if the customer agreed)

**Never put in notes**

- Diagnoses the customer did not state
- BMI, height, weight, or build
- Policy, premium, or coverage language
- Insults or slang for mental health, disability, or substance use
- Trauma details for PTSD
- Legal or driving history

**Example notes**

- `HX_NONE_REPORTED` — “All disease groups asked. Customer reports no clinician diagnoses. Confirmed.”
- `HX_DIABETES` — “Type 2 diabetes, diagnosed ~2018. Insulin started 2022. No kidney/eye/nerve complications named. Other groups no.”
- `HX_HEART` — “Stent 2021. Takes blood-pressure medication. No CHF reported. Other groups no.”
- `HX_CANCER` — “Colon cancer, surgery 2019, chemo finished 2020, oncology follow-up yearly. No recurrence reported.”
- `HX_COMPLETE_MULTI` — “Diabetes T2 on oral meds; COPD on inhalers; skipped mental-health group.”
- `HX_SKIPPED_SENSITIVE` — “Physical disease groups complete. Customer skipped mental/nervous and substance-use questions.”
- `HX_DECLINED` — “Consent given; declined to name any conditions. No diseases recorded.”
- `HX_EMERGENCY_STOP` — “Reported chest pain during call. Interview stopped. Directed to emergency care. History incomplete.”

---

## Map from call path to disposition

| What happened on the call | Disposition |
| --- | --- |
| All groups asked; no diseases | `HX_NONE_REPORTED` |
| All groups asked; one main disease with follow-ups | Matching `HX_CANCER` / `HX_DIABETES` / `HX_HEART` / etc., or `HX_COMPLETE` |
| Two or more disease groups yes | `HX_COMPLETE_MULTI` |
| Finished except skipped mental health or similar | `HX_SKIPPED_SENSITIVE` |
| Ran out of time; callback booked | `HX_CALLBACK` |
| Yes to a disease but missing name and timing | `HX_PARTIAL` or `HX_UNSURE` |
| Refused to share conditions | `HX_DECLINED` |
| No consent | `HX_CONSENT_DECLINED` |
| Education from FAQ only | `HX_EDUCATION_ONLY` |
| Possible emergency | `HX_EMERGENCY_STOP` |
| Customer too upset | `HX_DISTRESSED` |
| Corrected an old disease list | `HX_UPDATE` |

---

## Complete vs not complete

Treat the disease interview as **complete** when:

- Consent was given (or the goal was education-only and that is coded)
- Each disease group is yes, no, or skip
- Every “yes” has at least a condition name **or** a clear “name unknown + event described”
- You repeated the list back
- You did not diagnose

Not complete: `HX_PARTIAL`, `HX_DECLINED`, `HX_CONSENT_DECLINED`, `HX_CALLBACK`, `HX_UNSURE`, `HX_EMERGENCY_STOP`, `HX_DISTRESSED`, `HX_NO_CONTACT`, `HX_LANGUAGE_BARRIER`.

---

## After the call — agent checklist

- [ ] One primary disposition selected  
- [ ] Notes list conditions in the customer’s words  
- [ ] No BMI or policy language in notes  
- [ ] Skipped groups named  
- [ ] No guessed diagnoses  
- [ ] Emergency calls were not continued as a full interview  

---

## Related files

- `communication.md` — disease-group script and follow-ups  
- `faq.md` — why each disease group is asked  
- `objection.md` — if they hesitate; then choose `HX_DECLINED`, `HX_SKIPPED_SENSITIVE`, `HX_CALLBACK`, or a complete code