Please identify the documented ROS elements and the supporting findings. How does the documented ROS provide greater information about the CC and the HPI?

HPI: 68-year-old male presents to the Emergency Department with a four-day history of loose stools. Patient states that over the past several days he has had at least six to 10 loose, watery stools per day. No hematochezia or melena. He denies any fever or abdominal pain. No chest pain, shortness of breath, or peripheral edema. Did see his primary care physician several days ago, who increased his metoprolol to 100 mg daily.
PMH:
1. Coronary artery disease, status post CABG 2002
2. Sternal osteomyelitis, status post CABG
3. Gout
4. Chronic renal insufficiency, baseline creatinine 2.0
5. Ischemic cardiomyopathy, last echocardiogram 5/21/2012, EF 32%
6. Peripheral neuropathy
7. Diabetes Mellitus, type II (noninsulin dependent)
8. Hypertension
9. Appendiceal abscess, hospitalized 3/2010 to 4/2010, treated by conservative medical management only
10. Mild COPD
ROS: As per HPI.
Medications:
1. Metoprolol ER 100 mg by mouth daily (dose increased three days ago)
2. Amitriptiline 25 mg by mouth at night
3. Plavix 75 mg by mouth daily
4. Aspirin 81 mg by mouth daily
5. Lisinopril 20 mg by mouth daily
6. Spirinolactone 25 mg by mouth daily
7. Lasix 40 mg by mouth daily
8. Colchicine 0.6 mg by mouth daily
9. Simvistatin 20 mg by mouth every night
10. Glipizide 10 mg by mouth daily

What will be an ideal response?

ROS—Extended:
GI: No hematochezia
Constitutional: No fever
GI: No abdominal pain
Resp: No shortness of breath
CV: No chest pain or peripheral edema

The physician documents the ROS with the statement "As per HPI" which allows the documented findings to be duplicated in the recorded history, specifically the loose stools. In addition to the "As per HPI," the physician has documented that the patient has no hematochezia (or melena), which pertains to GI once again, but also constitutional, respiratory, and cardiovascular. These address three different organ systems that are directly related to the loose, watery stools. While the HPI describes the CC, the ROS describes the overall state of the patient's health prior to the patient's arrival in the E/M service visit.