CDS Hooks
3.0.0-ballot - R3 Normative Ballot

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

## : Non-Adherence Reason Clinical Selection

Page standards status: Trial-use | Maturity Level: 1

Raw xml | Download

    <ValueSet xmlns="http://hl7.org/fhir">
      <id value="non-adherence-reason-clinical"/>
      <language value="en"/>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ValueSet non-adherence-reason-clinical</b></p><a name="non-adherence-reason-clinical"> </a><a name="hcnon-adherence-reason-clinical"> </a><ul><li>Include these codes as defined in <a href="CodeSystem-non-adherence-reason-codes.html"><code>http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes</code></a><span title="Version is not explicitly stated, which means it is fixed to the version provided in this specification"> version &#x1F4E6;3.0.0-ballot</span><table class="none"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a href="CodeSystem-non-adherence-reason-codes.html#non-adherence-reason-codes-cds-not-applicable">cds-not-applicable</a></td><td style="color: #cccccc">PC CDS does not apply to patient</td><td>The CDS recommendation is irrelevant, completed, or the patient does not meet the criteria.</td></tr><tr><td><a href="CodeSystem-non-adherence-reason-codes.html#non-adherence-reason-codes-cds-suboptimal-context">cds-suboptimal-context</a></td><td style="color: #cccccc">PC CDS delivered in suboptimal context</td><td>The CDS was delivered at a time or to a recipient that made the action impossible or impractical to address.</td></tr><tr><td><a href="CodeSystem-non-adherence-reason-codes.html#non-adherence-reason-codes-recipient-disagrees-evidence">recipient-disagrees-evidence</a></td><td style="color: #cccccc">Recipient disagrees with recommendation because of issues with the evidence</td><td>The recipient (clinician or patient) has an objection based on the supporting evidence or conflicting advice/policy.</td></tr><tr><td><a href="CodeSystem-non-adherence-reason-codes.html#non-adherence-reason-codes-recipient-concerns-outcomes">recipient-concerns-outcomes</a></td><td style="color: #cccccc">Recipient has concerns regarding potential health outcomes</td><td>Concerns about the action's risk/benefit ratio, potential negative outcomes, or contraindications.</td></tr><tr><td><a href="CodeSystem-non-adherence-reason-codes.html#non-adherence-reason-codes-does-not-align-preferences">does-not-align-preferences</a></td><td style="color: #cccccc">Recommendation does not align with patient preferences or values</td><td>The action conflicts with the patient's personal, cultural, or religious beliefs, or they prefer an alternative.</td></tr><tr><td><a href="CodeSystem-non-adherence-reason-codes.html#non-adherence-reason-codes-not-convenient-feasible">not-convenient-feasible</a></td><td style="color: #cccccc">Recommendation is not convenient or feasible</td><td>Practical barriers related to cost, logistics, technology, or patient capability prevent the action.</td></tr><tr><td><a href="CodeSystem-non-adherence-reason-codes.html#non-adherence-reason-codes-action-completed">action-completed</a></td><td style="color: #cccccc">Recommended action was already completed</td><td>The action or procedure recommended by the CDS has already been performed.</td></tr><tr><td><a href="CodeSystem-non-adherence-reason-codes.html#non-adherence-reason-codes-patient-contraindication">patient-contraindication</a></td><td style="color: #cccccc">Patient has contraindication to recommended action</td><td>A patient factor (e.g., allergy, existing condition, previous reaction) explicitly rules out the recommended action.</td></tr><tr><td><a href="CodeSystem-non-adherence-reason-codes.html#non-adherence-reason-codes-patient-refuses">patient-refuses</a></td><td style="color: #cccccc">Patient refuses/declines (no context given)*</td><td>The patient has simply refused the recommendation without providing an explicit, detailed reason.</td></tr><tr><td><a href="CodeSystem-non-adherence-reason-codes.html#non-adherence-reason-codes-too-costly-uncovered">too-costly-uncovered</a></td><td style="color: #cccccc">Recommended action is too costly or not covered by insurance</td><td>Financial burden is a barrier, either due to the cost of the service or lack of insurance coverage.</td></tr><tr><td><a href="CodeSystem-non-adherence-reason-codes.html#non-adherence-reason-codes-service-not-available">service-not-available</a></td><td style="color: #cccccc">Treatment or service is not practically available</td><td>The required service, medication, or equipment is not accessible, either geographically or logistically.</td></tr><tr><td><a href="CodeSystem-non-adherence-reason-codes.html#non-adherence-reason-codes-recipient-does-not-understand">recipient-does-not-understand</a></td><td style="color: #cccccc">Recipient does not understand the recommended action or know how to perform the recommended action</td><td>The recipient (patient or clinician) lacks the necessary health literacy or procedural knowledge to execute the action.</td></tr></table></li></ul></div>
      </text>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
        <valueCode value="cds"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="trial-use"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
        <valueInteger value="1"/>
      </extension>
      <url
           value="http://terminology.hl7.org/ValueSet/non-adherence-reason-clinical"/>
      <version value="3.0.0-ballot"/>
      <name value="NonAdherenceReasonClinical"/>
      <title value="Non-Adherence Reason Clinical Selection"/>
      <status value="active"/>
      <experimental value="false"/>
      <date value="2025-12-14T21:46:53+00:00"/>
      <publisher value="Clinical Decision Support WG"/>
      <contact>
        <name value="Clinical Decision Support WG"/>
        <telecom>
          <system value="url"/>
          <value value="http://www.hl7.org/Special/committees/dss/index.cfm"/>
        </telecom>
        <telecom>
          <system value="email"/>
          <value value="cds@lists.HL7.org"/>
        </telecom>
      </contact>
      <description
                   value="A set of common and clinically relevant reasons for non-adherence, including all categories and key specific sub-codes for point-of-care selection."/>
      <jurisdiction>
        <coding>
          <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
          <code value="001"/>
          <display value="World"/>
        </coding>
      </jurisdiction>
      <compose>
        <include>
          <system
                  value="http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes"/>
          <concept>
            <code value="cds-not-applicable"/>
          </concept>
          <concept>
            <code value="cds-suboptimal-context"/>
          </concept>
          <concept>
            <code value="recipient-disagrees-evidence"/>
          </concept>
          <concept>
            <code value="recipient-concerns-outcomes"/>
          </concept>
          <concept>
            <code value="does-not-align-preferences"/>
          </concept>
          <concept>
            <code value="not-convenient-feasible"/>
          </concept>
          <concept>
            <code value="action-completed"/>
          </concept>
          <concept>
            <code value="patient-contraindication"/>
          </concept>
          <concept>
            <code value="patient-refuses"/>
          </concept>
          <concept>
            <code value="too-costly-uncovered"/>
          </concept>
          <concept>
            <code value="service-not-available"/>
          </concept>
          <concept>
            <code value="recipient-does-not-understand"/>
          </concept>
        </include>
      </compose>
    </ValueSet>