CDS Hooks
3.0.0-ballot - R3 Normative Ballot International flag

CDS Hooks, published by Clinical Decision Support WG. This guide is not an authorized publication; it is the continuous build for version 3.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cds-hooks/ and changes regularly. See the Directory of published versions

ValueSet: Non-Adherence Reason

Official URL: http://terminology.hl7.org/ValueSet/non-adherence-reason Version: 3.0.0-ballot
Standards status: Trial-use Active as of 2025-12-14 Maturity Level: 1 Computable Name: NonAdherenceReason

A set of codes capturing all reasons why a Patient Care Clinical Decision Support (PC CDS) recommendation may not be followed, drawn from the CDS-NonAdherence-Reason CodeSystem.

References

This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

Logical Definition (CLD)

 

Expansion

Expansion performed internally based on codesystem Non-Adherence Reason Codes v3.0.0-ballot (CodeSystem)

This value set contains 35 concepts

LevelSystemCodeDisplay (en)DefinitionJSONXML
1http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes  cds-not-applicablePC CDS does not apply to patientThe CDS recommendation is irrelevant, completed, or the patient does not meet the criteria.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    patient-ineligiblePatient does not meet eligibility for recommended actionThe patient does not satisfy the criteria (e.g., age, condition, lab result) for the recommended action.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    indication-order-existsPatient has indication/order for intended actionThe recommended action is already indicated or ordered in the patient's record, making the CDS redundant.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    action-completedRecommended action was already completedThe action or procedure recommended by the CDS has already been performed.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    action-unsuccessfulRecommended action was previously unsuccessfulThe recommended action was attempted before and failed to achieve the desired outcome.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    action-performed-no-adverse-effectIntended action was performed previously without adverse effectA previously performed action that was the subject of the CDS did not cause harm, suggesting the action is safe despite the CDS warning.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    action-not-priorityRecommended action is not relevant or a priority in current state of healthThe patient's acute or chronic conditions require more immediate attention than the action recommended by the CDS.
1http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes  cds-suboptimal-contextPC CDS delivered in suboptimal contextThe CDS was delivered at a time or to a recipient that made the action impossible or impractical to address.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    limited-timeCould not address recommended action due to limited timeThe recipient had insufficient time during the current patient encounter or workflow step to act on the recommendation.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    wrong-time-workflowPC CDS delivered at wrong time in workflow or patient lifecycleThe alert appeared at a point in the workflow or patient's care journey where it could not be practically acted upon.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    inappropriate-recipientPC CDS delivered to inappropriate recipient/roleThe person receiving the recommendation (e.g., a nurse, clerk) is not authorized or responsible for performing the action.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    need-more-infoCould not address recommended action due to need for more information/pending results/pending consultThe recipient requires additional data (e.g., a lab result, imaging) or a specialist's opinion before the action can be safely or definitively taken.
1http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes  recipient-disagrees-evidenceRecipient disagrees with recommendation because of issues with the evidenceThe recipient (clinician or patient) has an objection based on the supporting evidence or conflicting advice/policy.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    does-not-align-latest-evidenceRecommended action does not align with the latest evidenceThe recipient believes the CDS rule is outdated compared to current medical literature or best practices.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    expert-contradictsAdvice from expert contradicts the recommended actionGuidance received from a specialist or recognized authority conflicts with the CDS recommendation.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    policy-contradictsInstitutional policy/guideline contradicts the recommended actionThe recommendation conflicts with the official procedures, policies, or local guidelines of the healthcare facility.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    recipient-does-not-trustRecipient does not agree with or trust the recommended actionThe recipient fundamentally disbelieves the validity or necessity of the CDS action.
1http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes  recipient-concerns-outcomesRecipient has concerns regarding potential health outcomesConcerns about the action's risk/benefit ratio, potential negative outcomes, or contraindications.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    risk-benefit-ratioRecipient assessment of risk/benefit ratioThe recipient determines that the potential risks of the action outweigh the anticipated benefits for this specific patient.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    mitigate-risk-negative-outcomeAction taken to mitigate risk of negative outcomeThe recommended action was superseded by an alternative measure taken to specifically avoid a known potential adverse event.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    likely-negative-health-outcomesRecommended action likely to have negative health outcomesThe recipient believes the action, if taken, would predictably lead to an adverse patient outcome (e.g., severe side effect).
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    patient-contraindicationPatient has contraindication to recommended actionA patient factor (e.g., allergy, existing condition, previous reaction) explicitly rules out the recommended action.
1http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes  does-not-align-preferencesRecommendation does not align with patient preferences or valuesThe action conflicts with the patient's personal, cultural, or religious beliefs, or they prefer an alternative.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    patient-fears-discomfortPatient fears discomfort from complying with recommended actionThe patient is unwilling to proceed due to anticipated pain, anxiety, or general discomfort associated with the action.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    patient-does-not-want-changePatient does not want to change behavior or believes the change is unnecessaryThe patient lacks motivation for lifestyle change or disagrees with the premise that a change is needed for their health.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    cultural-religious-reasonPatient has a cultural or religious reason for not following recommended actionThe patient's deeply held cultural or religious beliefs prohibit them from accepting the recommendation (e.g., blood transfusions).
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    prefers-alternativePatient prefers an alternative approach or treatmentThe patient wishes to pursue a different, non-recommended treatment or approach (e.g., holistic medicine).
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    patient-refusesPatient refuses/declines (no context given)*The patient has simply refused the recommendation without providing an explicit, detailed reason.
1http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes  not-convenient-feasibleRecommendation is not convenient or feasiblePractical barriers related to cost, logistics, technology, or patient capability prevent the action.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    inadequate-supportPatient has inadequate caregiver/social supportThe patient lacks the necessary assistance from family or caregivers to comply with the action.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    service-not-availableTreatment or service is not practically availableThe required service, medication, or equipment is not accessible, either geographically or logistically.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    implementation-challengesRecommended action cannot be implemented due to technology/challengesTechnical issues, system downtime, or complexity of the EHR/device prevent the action from being recorded or performed.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    too-costly-uncoveredRecommended action is too costly or not covered by insuranceFinancial burden is a barrier, either due to the cost of the service or lack of insurance coverage.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    recipient-does-not-understandRecipient does not understand the recommended action or know how to perform the recommended actionThe recipient (patient or clinician) lacks the necessary health literacy or procedural knowledge to execute the action.
2http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes    comorbidity-disabilityPatient has co-morbidity or disability that hinders them from completing recommended actionAn unrelated or co-existing physical/mental condition (e.g., severe arthritis, dementia) makes the action impossible for the patient.

Description of the above table(s).