ServiceRequest needs to accommodate the workflow to allow for indications why a service is not recommended (i.e., .intent = plan) or not ordered (i.e., .intent = order). Clinical decision support artifacts address placing orders or recommmending activities to patients, including referrals to other providers, procedures, etc. The CDS artifacts may indicate rationale to avoid following the recommendations such that the provider (or patient) can select a valid reason and save that rationale for failing to comply in the record. Such a .notDoneReason metadata element can then inform the CDS event-condition-action rule to avoid re-alerting the provider in the future (or to "snooze" the alert to a later time).