RTF Note

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Approval Status

  • Approval Status: Pending
  • Example Task Force: 10/8/2020

C-CDA 2.1 Example:

  • 2.16.840.1.113883. (Companion Guide Appendix A)

Reference to full CDA sample:

  • N/A

Validation location


  • This is an example of how to include rich text in a C-CDA Note Activity.


  • Matt Szczepankiewicz, mszczepa@epic.com (GitHub: mjszczep)


  • Note, Note Activity, Notes, RTF, Rich Text


  • TBD


Example: download example view on GitHub

    <!-- Notes Section -->
    <templateId root="2.16.840.1.113883." extension="2016-11-01"/>
    <code code="34746-8" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Nurse Note"/>
    <title>Nursing Notes</title>
            <!-- This is the Plain Text representation of the RTF, it must FULLY preserve the meaning of the embedded RTF. -->
            <!-- Systems receiving a section with RTF SHALL be capable of displaying the section.text. -->
            <item ID="note1"> 
                <caption>Nursing Note written by Nick Nurse</caption>
                <paragraph>Completed rounds; no incident</paragraph>
    <!-- When converting RTF to Plain Text, it's important to preserve the meaning in RTF. For example, strikethrough and other formatting which change the meaning SHALL be considered -->
    <!-- Systems that render RTF (OPTIONAL) should use caution since malicious content may be embedded in RTF-->
    <!-- Note Activity (extra markup removed to focus on <text>) -->
    <entry typeCode="DRIV">
        <act classCode="ACT" moodCode="EVN">
            <templateId root="2.16.840.1.113883." extension="2016-11-01"/>
            <code code="34109-9" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName=”Note”>
                <translation code="34746-8" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Nurse Note" />

            <text mediaType="text/rtf" representation="B64">e1xydGYxXGFuc2lcYW5zaWNwZzEyNTJcZGVmZjBcbm91aWNvbXBhdFxkZWZsYW5nMTAzM3tcZm9udHRibHtcZjBcZm5pbFxmY2hhcnNldDAgQ2FsaWJyaTt9fQ0Ke1wqXGdlbmVyYXRvciBSaWNoZWQyMCA2LjMuOTYwMH1cdmlld2tpbmQ0XHVjMSANClxwYXJkXHNhMjAwXHNsMjc2XHNsbXVsdDFcZjBcZnMyMlxsYW5nOSBDb21wbGV0ZWQgcm91bmRzOyBubyBpbmNpZGVudFxwYXINCn0NCiA=
                <reference value="#note1"/>
            <!-- Author Participant information here -->
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