cds-not-applicable | PC CDS does not apply to patient | The CDS recommendation is irrelevant, completed, or the patient does not meet the criteria. |
└patient-ineligible | Patient does not meet eligibility for recommended action | The patient does not satisfy the criteria (e.g., age, condition, lab result) for the recommended action. |
└indication-order-exists | Patient has indication/order for intended action | The recommended action is already indicated or ordered in the patient's record, making the CDS redundant. |
└action-completed | Recommended action was already completed | The action or procedure recommended by the CDS has already been performed. |
└action-unsuccessful | Recommended action was previously unsuccessful | The recommended action was attempted before and failed to achieve the desired outcome. |
└action-performed-no-adverse-effect | Intended action was performed previously without adverse effect | A previously performed action that was the subject of the CDS did not cause harm, suggesting the action is safe despite the CDS warning. |
└action-not-priority | Recommended action is not relevant or a priority in current state of health | The patient's acute or chronic conditions require more immediate attention than the action recommended by the CDS. |
cds-suboptimal-context | PC CDS delivered in suboptimal context | The CDS was delivered at a time or to a recipient that made the action impossible or impractical to address. |
└limited-time | Could not address recommended action due to limited time | The recipient had insufficient time during the current patient encounter or workflow step to act on the recommendation. |
└wrong-time-workflow | PC CDS delivered at wrong time in workflow or patient lifecycle | The alert appeared at a point in the workflow or patient's care journey where it could not be practically acted upon. |
└inappropriate-recipient | PC CDS delivered to inappropriate recipient/role | The person receiving the recommendation (e.g., a nurse, clerk) is not authorized or responsible for performing the action. |
└need-more-info | Could not address recommended action due to need for more information/pending results/pending consult | The recipient requires additional data (e.g., a lab result, imaging) or a specialist's opinion before the action can be safely or definitively taken. |
recipient-disagrees-evidence | Recipient disagrees with recommendation because of issues with the evidence | The recipient (clinician or patient) has an objection based on the supporting evidence or conflicting advice/policy. |
└does-not-align-latest-evidence | Recommended action does not align with the latest evidence | The recipient believes the CDS rule is outdated compared to current medical literature or best practices. |
└expert-contradicts | Advice from expert contradicts the recommended action | Guidance received from a specialist or recognized authority conflicts with the CDS recommendation. |
└policy-contradicts | Institutional policy/guideline contradicts the recommended action | The recommendation conflicts with the official procedures, policies, or local guidelines of the healthcare facility. |
└recipient-does-not-trust | Recipient does not agree with or trust the recommended action | The recipient fundamentally disbelieves the validity or necessity of the CDS action. |
recipient-concerns-outcomes | Recipient has concerns regarding potential health outcomes | Concerns about the action's risk/benefit ratio, potential negative outcomes, or contraindications. |
└risk-benefit-ratio | Recipient assessment of risk/benefit ratio | The recipient determines that the potential risks of the action outweigh the anticipated benefits for this specific patient. |
└mitigate-risk-negative-outcome | Action taken to mitigate risk of negative outcome | The recommended action was superseded by an alternative measure taken to specifically avoid a known potential adverse event. |
└likely-negative-health-outcomes | Recommended action likely to have negative health outcomes | The recipient believes the action, if taken, would predictably lead to an adverse patient outcome (e.g., severe side effect). |
└patient-contraindication | Patient has contraindication to recommended action | A patient factor (e.g., allergy, existing condition, previous reaction) explicitly rules out the recommended action. |
does-not-align-preferences | Recommendation does not align with patient preferences or values | The action conflicts with the patient's personal, cultural, or religious beliefs, or they prefer an alternative. |
└patient-fears-discomfort | Patient fears discomfort from complying with recommended action | The patient is unwilling to proceed due to anticipated pain, anxiety, or general discomfort associated with the action. |
└patient-does-not-want-change | Patient does not want to change behavior or believes the change is unnecessary | The patient lacks motivation for lifestyle change or disagrees with the premise that a change is needed for their health. |
└cultural-religious-reason | Patient has a cultural or religious reason for not following recommended action | The patient's deeply held cultural or religious beliefs prohibit them from accepting the recommendation (e.g., blood transfusions). |
└prefers-alternative | Patient prefers an alternative approach or treatment | The patient wishes to pursue a different, non-recommended treatment or approach (e.g., holistic medicine). |
└patient-refuses | Patient refuses/declines (no context given)* | The patient has simply refused the recommendation without providing an explicit, detailed reason. |
not-convenient-feasible | Recommendation is not convenient or feasible | Practical barriers related to cost, logistics, technology, or patient capability prevent the action. |
└inadequate-support | Patient has inadequate caregiver/social support | The patient lacks the necessary assistance from family or caregivers to comply with the action. |
└service-not-available | Treatment or service is not practically available | The required service, medication, or equipment is not accessible, either geographically or logistically. |
└implementation-challenges | Recommended action cannot be implemented due to technology/challenges | Technical issues, system downtime, or complexity of the EHR/device prevent the action from being recorded or performed. |
└too-costly-uncovered | Recommended action is too costly or not covered by insurance | Financial burden is a barrier, either due to the cost of the service or lack of insurance coverage. |
└recipient-does-not-understand | Recipient does not understand the recommended action or know how to perform the recommended action | The recipient (patient or clinician) lacks the necessary health literacy or procedural knowledge to execute the action. |
└comorbidity-disability | Patient has co-morbidity or disability that hinders them from completing recommended action | An unrelated or co-existing physical/mental condition (e.g., severe arthritis, dementia) makes the action impossible for the patient. |