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

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    {
      "resourceType" : "ValueSet",
      "id" : "non-adherence-reason-clinical",
      "language" : "en",
      "text" : {
        "status" : "extensions",
        "div" : "<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>"
      },
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
          "valueCode" : "cds"
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
          "valueCode" : "trial-use"
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
          "valueInteger" : 1
        }
      ],
      "url" : "http://terminology.hl7.org/ValueSet/non-adherence-reason-clinical",
      "version" : "3.0.0-ballot",
      "name" : "NonAdherenceReasonClinical",
      "title" : "Non-Adherence Reason Clinical Selection",
      "status" : "active",
      "experimental" : false,
      "date" : "2025-12-14T21:46:53+00:00",
      "publisher" : "Clinical Decision Support WG",
      "contact" : [
        {
          "name" : "Clinical Decision Support WG",
          "telecom" : [
            {
              "system" : "url",
              "value" : "http://www.hl7.org/Special/committees/dss/index.cfm"
            },
            {
              "system" : "email",
              "value" : "cds@lists.HL7.org"
            }
          ]
        }
      ],
      "description" : "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" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
              "code" : "001",
              "display" : "World"
            }
          ]
        }
      ],
      "compose" : {
        "include" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/non-adherence-reason-codes",
            "concept" : [
              {
                "code" : "cds-not-applicable"
              },
              {
                "code" : "cds-suboptimal-context"
              },
              {
                "code" : "recipient-disagrees-evidence"
              },
              {
                "code" : "recipient-concerns-outcomes"
              },
              {
                "code" : "does-not-align-preferences"
              },
              {
                "code" : "not-convenient-feasible"
              },
              {
                "code" : "action-completed"
              },
              {
                "code" : "patient-contraindication"
              },
              {
                "code" : "patient-refuses"
              },
              {
                "code" : "too-costly-uncovered"
              },
              {
                "code" : "service-not-available"
              },
              {
                "code" : "recipient-does-not-understand"
              }
            ]
          }
        ]
      }
    }