# CND Composition - Clinical Note Document v26.0.0

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# Clinical Note Document

26.0.0
AU

*  [FHIR IGs](https://implementer.digitalhealth.gov.au/fhir-resources) 
*  [Implementer Hub](https://implementer.digitalhealth.gov.au/) 
*  [Agency site](https://www.digitalhealth.gov.au) 

* [**Table of Contents**](toc.md)
* [**FHIR Artefacts**](fhir-artefacts.md)
* [**Artefacts Summary**](artifacts.md)
* **CND Composition**

## Resource Profile: CND Composition 

| | |
| :--- | :--- |
| *Official URL*:http://digitalhealth.gov.au/fhir/cnd/StructureDefinition/cnd-composition | *Version*:26.0.0 |
| Active as of 2026-06-19 | *Computable Name*:CND_Composition |
| **Copyright/Legal**: This content is licensed under a Creative Commons Attribution 4.0 International License. See [https://creativecommons.org/licenses/by/4.0/](https://creativecommons.org/licenses/by/4.0/) | |

 
This profile specialises the [FHIR Clinical Document Composition Profile](https://hl7.org/fhir/uv/fhir-clinical-document/en/StructureDefinition-clinical-document-composition.html) for the purposes of a Clinical Note Document in Australia. All the guidelines and conformance requirements defined of the FHIR Clinical Document Composition apply. 

 
This profile defines the composition structure for a Clinical Note Document in Australia, ensuring consistent organisation of clinical note content including narrative sections and medication information for exchange between healthcare providers. 

**Usages:**

* Use this Profile: [CND Bundle](StructureDefinition-cnd-bundle.md)
* Examples for this Profile: [Composition/ex-composition-anne](Composition-ex-composition-anne.md)

You can also check for [usages in the FHIR IG Statistics](https://packages2.fhir.org/xig/resource/au.gov.digitalhealth.cnd|current/StructureDefinition/StructureDefinition-cnd-composition.json)

### Formal Views of Profile Content

 [Description of Profiles, Differentials, Snapshots and how the different presentations work](http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#structure-definitions). 

 

Other representations of profile: [CSV](StructureDefinition-cnd-composition.csv), [Excel](StructureDefinition-cnd-composition.xlsx), [Schematron](StructureDefinition-cnd-composition.sch) 

 ![](assets/images/adha-logo-light.svg) 

IG © 2026+ [Australian Digital Health Agency](https://www.digitalhealth.gov.au). Package au.gov.digitalhealth.cnd#26.0.0 based on [FHIR 4.0.1](http://hl7.org/fhir/R4/). Generated 2026-06-19

Links: [Table of Contents](toc.md) | [QA Report](qa.md) | [Version History](https://fhir.digitalhealth.gov.au/dh/history.html) | [Report an issue or propose a change](mailto:help@digitalhealth.gov.au) 

Publisher: [Australian Digital Health Agency](https://www.digitalhealth.gov.au) | ABN: 84 425 496 912, Level 25, 175 Liverpool Street, Sydney, NSW 2000 | Phone: [1300 901 001](tel:1300901001) | Email: [help@digitalhealth.gov.au](mailto:help@digitalhealth.gov.au) | [https://www.digitalhealth.gov.au](https://www.digitalhealth.gov.au) | [Privacy policy](https://www.digitalhealth.gov.au/about-us/policies-privacy-and-reporting/privacy-policy) | [Terms of Use](https://www.digitalhealth.gov.au/about-us/policies-privacy-and-reporting/terms-of-use)

![](cc0.png)
The Australian Digital Health Agency acknowledges the Traditional Custodians of Country throughout Australia, and their continuing connection to land, sea and community. We pay our respects to them and their cultures, and to Elders, past and present.



## Resource Content

```json
{
  "resourceType" : "StructureDefinition",
  "id" : "cnd-composition",
  "url" : "http://digitalhealth.gov.au/fhir/cnd/StructureDefinition/cnd-composition",
  "version" : "26.0.0",
  "name" : "CND_Composition",
  "title" : "CND Composition",
  "status" : "active",
  "date" : "2026-06-19T14:17:49+10:00",
  "publisher" : "Australian Digital Health Agency",
  "contact" : [{
    "name" : "Australian Digital Health Agency",
    "telecom" : [{
      "system" : "url",
      "value" : "https://www.digitalhealth.gov.au"
    },
    {
      "system" : "email",
      "value" : "help@digitalhealth.gov.au"
    }]
  },
  {
    "name" : "Australian Digital Health Agency",
    "telecom" : [{
      "system" : "email",
      "value" : "help@digitalhealth.gov.au",
      "use" : "work"
    }]
  }],
  "description" : "This profile specialises the [FHIR Clinical Document Composition Profile](https://hl7.org/fhir/uv/fhir-clinical-document/en/StructureDefinition-clinical-document-composition.html) for the purposes of a Clinical Note Document in Australia. All the guidelines and conformance requirements defined of the FHIR Clinical Document Composition apply.",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "urn:iso:std:iso:3166",
      "code" : "AU",
      "display" : "Australia"
    }]
  }],
  "purpose" : "This profile defines the composition structure for a Clinical Note Document in Australia, ensuring consistent organisation of clinical note content including narrative sections and medication information for exchange between healthcare providers. ",
  "copyright" : "This content is licensed under a Creative Commons Attribution 4.0 International License. See [https://creativecommons.org/licenses/by/4.0/](https://creativecommons.org/licenses/by/4.0/)",
  "fhirVersion" : "4.0.1",
  "mapping" : [{
    "identity" : "workflow",
    "uri" : "http://hl7.org/fhir/workflow",
    "name" : "Workflow Pattern"
  },
  {
    "identity" : "rim",
    "uri" : "http://hl7.org/v3",
    "name" : "RIM Mapping"
  },
  {
    "identity" : "cda",
    "uri" : "http://hl7.org/v3/cda",
    "name" : "CDA (R2)"
  },
  {
    "identity" : "fhirdocumentreference",
    "uri" : "http://hl7.org/fhir/documentreference",
    "name" : "FHIR DocumentReference"
  },
  {
    "identity" : "w5",
    "uri" : "http://hl7.org/fhir/fivews",
    "name" : "FiveWs Pattern Mapping"
  }],
  "kind" : "resource",
  "abstract" : false,
  "type" : "Composition",
  "baseDefinition" : "http://hl7.org/fhir/uv/fhir-clinical-document/StructureDefinition/clinical-document-composition",
  "derivation" : "constraint",
  "differential" : {
    "element" : [{
      "id" : "Composition",
      "path" : "Composition",
      "short" : "Clinical Note Document Composition",
      "constraint" : [{
        "key" : "inv-01-narrative-or-medications-section",
        "severity" : "error",
        "human" : "Composition must have either a sectionNarrative or a sectionMedications section.",
        "expression" : "section.where(code.coding.where(code = '61149-1').exists()).exists() or section.where(code.coding.where(code = '10160-0').exists()).exists()",
        "source" : "http://digitalhealth.gov.au/fhir/cnd/StructureDefinition/cnd-composition"
      },
      {
        "key" : "inv-02-narrative-text-or-entry",
        "severity" : "error",
        "human" : "section[sectionNarrative] must have either text or at least one entry with a DocumentReference.",
        "expression" : "section.where(code.coding.where(code = '61149-1').exists()).all(text.exists() or entry.resolve().ofType(DocumentReference).exists())",
        "source" : "http://digitalhealth.gov.au/fhir/cnd/StructureDefinition/cnd-composition"
      }]
    },
    {
      "id" : "Composition.extension",
      "path" : "Composition.extension",
      "min" : 1
    },
    {
      "id" : "Composition.extension:information-recipient",
      "path" : "Composition.extension",
      "sliceName" : "information-recipient",
      "min" : 1
    },
    {
      "id" : "Composition.extension:information-recipient.extension:type",
      "path" : "Composition.extension.extension",
      "sliceName" : "type"
    },
    {
      "id" : "Composition.extension:information-recipient.extension:type.value[x]",
      "path" : "Composition.extension.extension.value[x]",
      "binding" : {
        "strength" : "required",
        "valueSet" : "http://digitalhealth.gov.au/fhir/cnd/ValueSet/information-recipient-type-vs"
      }
    },
    {
      "id" : "Composition.extension:information-recipient.extension:party",
      "path" : "Composition.extension.extension",
      "sliceName" : "party"
    },
    {
      "id" : "Composition.extension:information-recipient.extension:party.value[x]",
      "path" : "Composition.extension.extension.value[x]",
      "short" : "If Practitioner details are known, use PractitionerRole profile. Otherwise, use the Organization profile.",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://digitalhealth.gov.au/fhir/cnd/StructureDefinition/cnd-organization",
        "http://digitalhealth.gov.au/fhir/cnd/StructureDefinition/cnd-department",
        "http://digitalhealth.gov.au/fhir/cnd/StructureDefinition/cnd-practitionerrole"]
      }]
    },
    {
      "id" : "Composition.type",
      "path" : "Composition.type",
      "patternCodeableConcept" : {
        "coding" : [{
          "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/nctis-data-components-1",
          "code" : "100.32054"
        }]
      }
    },
    {
      "id" : "Composition.category:ClinicalNoteCategory",
      "path" : "Composition.category",
      "sliceName" : "ClinicalNoteCategory",
      "short" : "Clinical Note Document",
      "min" : 0,
      "max" : "1",
      "patternCodeableConcept" : {
        "coding" : [{
          "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/nctis-data-components-1",
          "code" : "100.32053"
        }]
      },
      "mustSupport" : true
    },
    {
      "id" : "Composition.category:ClinicalNoteCategory.text",
      "path" : "Composition.category.text",
      "patternString" : "Residential Care Clinical Document"
    },
    {
      "id" : "Composition.subject",
      "path" : "Composition.subject",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://digitalhealth.gov.au/fhir/cnd/StructureDefinition/cnd-patient"]
      }]
    },
    {
      "id" : "Composition.author",
      "path" : "Composition.author",
      "short" : "If Practitioner details are known, use PractitionerRole profile. Otherwise, use the Organization profile.",
      "max" : "1",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://digitalhealth.gov.au/fhir/cnd/StructureDefinition/cnd-organization",
        "http://digitalhealth.gov.au/fhir/cnd/StructureDefinition/cnd-practitionerrole"]
      }]
    },
    {
      "id" : "Composition.custodian",
      "path" : "Composition.custodian",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://digitalhealth.gov.au/fhir/cnd/StructureDefinition/cnd-organization"]
      }]
    },
    {
      "id" : "Composition.section",
      "path" : "Composition.section",
      "slicing" : {
        "discriminator" : [{
          "type" : "pattern",
          "path" : "code"
        }],
        "ordered" : false,
        "rules" : "open"
      },
      "short" : "Sections composing the Clinical Note Document.",
      "definition" : "The root of the sections that make up the Clinical Note Document composition."
    },
    {
      "id" : "Composition.section.extension:section-note",
      "path" : "Composition.section.extension",
      "sliceName" : "section-note",
      "short" : "Additional notes that apply to the section (but not to a specific resource).",
      "definition" : "Additional notes that apply to the section (but not to a specific resource).",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Extension",
        "profile" : ["http://hl7.org/fhir/StructureDefinition/note|5.3.0"]
      }]
    },
    {
      "id" : "Composition.section:sectionNarrative",
      "path" : "Composition.section",
      "sliceName" : "sectionNarrative",
      "short" : "Narrative Section",
      "definition" : "The narrative section details relevant clinical data for the identified patient.",
      "min" : 0,
      "max" : "1",
      "mustSupport" : true
    },
    {
      "id" : "Composition.section:sectionNarrative.extension:section-note",
      "path" : "Composition.section.extension",
      "sliceName" : "section-note",
      "short" : "Additional notes that apply to the section (but not to a specific resource).",
      "definition" : "Additional notes that apply to the section (but not to a specific resource).",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Extension",
        "profile" : ["http://hl7.org/fhir/StructureDefinition/note|5.3.0"]
      }]
    },
    {
      "id" : "Composition.section:sectionNarrative.code",
      "path" : "Composition.section.code",
      "min" : 1,
      "patternCodeableConcept" : {
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "61149-1"
        }]
      }
    },
    {
      "id" : "Composition.section:sectionNarrative.entry",
      "path" : "Composition.section.entry",
      "slicing" : {
        "discriminator" : [{
          "type" : "profile",
          "path" : "resolve()"
        }],
        "rules" : "open"
      },
      "short" : "Attachments that are relevant to this section.",
      "definition" : "The narrative section may be supported by any number of attachments in any format",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/DocumentReference"]
      }]
    },
    {
      "id" : "Composition.section:sectionNarrative.entry:attachment",
      "path" : "Composition.section.entry",
      "sliceName" : "attachment",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://digitalhealth.gov.au/fhir/cnd/StructureDefinition/cnd-documentreference"]
      }],
      "mustSupport" : true
    },
    {
      "id" : "Composition.section:sectionMedications",
      "path" : "Composition.section",
      "sliceName" : "sectionMedications",
      "short" : "Medications Section",
      "definition" : "The medications section details current and/or past medications taken by the patient. This is not a prescription or a legally recognised medicine chart.",
      "min" : 0,
      "max" : "1",
      "mustSupport" : true
    },
    {
      "id" : "Composition.section:sectionMedications.extension:section-note",
      "path" : "Composition.section.extension",
      "sliceName" : "section-note",
      "short" : "Additional notes that apply to the section (but not to a specific resource).",
      "definition" : "Additional notes that apply to the section (but not to a specific resource).",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Extension",
        "profile" : ["http://hl7.org/fhir/StructureDefinition/note|5.3.0"]
      }]
    },
    {
      "id" : "Composition.section:sectionMedications.code",
      "path" : "Composition.section.code",
      "min" : 1,
      "patternCodeableConcept" : {
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "10160-0"
        }]
      }
    },
    {
      "id" : "Composition.section:sectionMedications.text",
      "path" : "Composition.section.text",
      "min" : 1
    },
    {
      "id" : "Composition.section:sectionMedications.entry",
      "path" : "Composition.section.entry",
      "slicing" : {
        "discriminator" : [{
          "type" : "profile",
          "path" : "resolve()"
        }],
        "rules" : "open"
      },
      "short" : "Medication statements that are relevant to this section.",
      "definition" : "The medications section may include any number of relevant medication statements",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://digitalhealth.gov.au/fhir/cnd/StructureDefinition/cnd-medicationstatement"]
      }]
    },
    {
      "id" : "Composition.section:sectionMedications.entry:medicationStatement",
      "path" : "Composition.section.entry",
      "sliceName" : "medicationStatement",
      "min" : 0,
      "max" : "*",
      "mustSupport" : true
    }]
  }
}

```
