# CPS.3.12 Manage Health Information Record Quality (Function) - HL7 Electronic Health Record System Functional Model, Release 2.1.1 v2.1.1

## Requirements: CPS.3.12 Manage Health Information Record Quality (Function) 

 
Support grammatical and lexical integrity of the health record by providing medical spelling, thesaurus and grammar ready assistance during clinical documentation as well as enabling shortcuts for pre-defined text. 



## Resource Content

```json
{
  "resourceType" : "Requirements",
  "id" : "EHRSFMR2-CPS.3.12",
  "meta" : {
    "profile" : [
      "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/FMFunction"
    ]
  },
  "language" : "en",
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode" : "normative"
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "ehr"
    }
  ],
  "url" : "http://hl7.org/ehrs/uv/ehrsfmr2/Requirements/EHRSFMR2-CPS.3.12",
  "version" : "2.1.1",
  "name" : "CPS_3_12_Manage_Health_Information_Record_Quality",
  "title" : "CPS.3.12 Manage Health Information Record Quality (Function)",
  "status" : "active",
  "date" : "2025-12-13T09:06:06+00:00",
  "publisher" : "HL7 International / Electronic Health Records",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/ehr"
        }
      ]
    }
  ],
  "description" : "Support grammatical and lexical integrity of the health record by providing medical spelling, thesaurus and grammar ready assistance during clinical documentation as well as enabling shortcuts for pre-defined text.",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code" : "001",
          "display" : "World"
        }
      ]
    }
  ],
  "purpose" : "Users and patients will benefit from features that enable rapid checking of spelling and grammar, a medical thesaurus function as well as text shortcuts to expand pre-defined text during clinical documentation. A shortcut may also be defined to trigger a specific system function such as the opening of a pre-defined template. These functions may be defined at an enterprise level based on scope of practice, organizational policy, and/or jurisdictional law. However, pre-defined text may also be configured by provider or provider type.",
  "statement" : [
    {
      "extension" : [
        {
          "url" : "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent",
          "valueBoolean" : false
        }
      ],
      "key" : "EHRSFMR2-CPS.3.12-01",
      "label" : "CPS.3.12#01",
      "conformance" : ["SHOULD"],
      "conditionality" : false,
      "requirement" : "The system SHOULD determine and present the correct medical spelling based on an integrated realm-based medical spelling function."
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent",
          "valueBoolean" : false
        }
      ],
      "key" : "EHRSFMR2-CPS.3.12-02",
      "label" : "CPS.3.12#02",
      "conformance" : ["SHOULD"],
      "conditionality" : false,
      "requirement" : "The system SHOULD determine and present the correct medical thesaurus based on an integrated realm-based medical thesaurus function."
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent",
          "valueBoolean" : false
        }
      ],
      "key" : "EHRSFMR2-CPS.3.12-03",
      "label" : "CPS.3.12#03",
      "conformance" : ["SHOULD"],
      "conditionality" : false,
      "requirement" : "The system SHOULD determine and present the correct medical grammar based on an integrated realm-based medical grammar function."
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent",
          "valueBoolean" : false
        }
      ],
      "key" : "EHRSFMR2-CPS.3.12-04",
      "label" : "CPS.3.12#04",
      "conformance" : ["SHOULD"],
      "conditionality" : false,
      "requirement" : "The system SHOULD determine and present the appropriate pre-defined text when an associated shortcut is entered during clinical documentation."
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent",
          "valueBoolean" : false
        }
      ],
      "key" : "EHRSFMR2-CPS.3.12-05",
      "label" : "CPS.3.12#05",
      "conformance" : ["SHOULD"],
      "conditionality" : false,
      "requirement" : "The system SHOULD determine and present personally pre-defined text when triggered by the associated macro based on an integrated personally pre-defined-text function."
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent",
          "valueBoolean" : false
        }
      ],
      "key" : "EHRSFMR2-CPS.3.12-06",
      "label" : "CPS.3.12#06",
      "conformance" : ["SHOULD"],
      "conditionality" : false,
      "requirement" : "The system SHOULD provide the ability to manage shortcut for the insertion of templates (e.g., insert new patient assessment template when Ctrl-A is entered)."
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent",
          "valueBoolean" : false
        }
      ],
      "key" : "EHRSFMR2-CPS.3.12-07",
      "label" : "CPS.3.12#07",
      "conformance" : ["SHOULD"],
      "conditionality" : false,
      "requirement" : "The system SHOULD determine and present the appropriate template when the associated shortcut is entered."
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent",
          "valueBoolean" : false
        }
      ],
      "key" : "EHRSFMR2-CPS.3.12-08",
      "label" : "CPS.3.12#08",
      "conformance" : ["MAY"],
      "conditionality" : false,
      "requirement" : "The system MAY provide the ability to manage an integrated enterprise pre-defined text function and associated macros."
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent",
          "valueBoolean" : false
        }
      ],
      "key" : "EHRSFMR2-CPS.3.12-09",
      "label" : "CPS.3.12#09",
      "conformance" : ["MAY"],
      "conditionality" : false,
      "requirement" : "The system MAY provide the ability to manage an integrated personally pre-defined text function and associated macros."
    }
  ]
}

```
