@cosyte/synth 0.1.9 → 0.1.10

package/dist/deid/index.cjs

@@ -73,7 +73,11 @@ var SYNTH_FATAL_CODES = Object.freeze({
   SYNTH_INVALID_DECIMAL: "SYNTH_INVALID_DECIMAL",
   /** An integer range was requested with its maximum below its minimum. Fatal. */
   SYNTH_INVALID_RANGE: "SYNTH_INVALID_RANGE",
-  /** A value was drawn from an empty pool. Fatal, never a fabricated substitute. */
+  /**
+   * A value was drawn from an empty pool. Fatal, never a fabricated substitute. A corpus given an
+   * empty `mix`, `triggers` or `quirks` list (or a profile whose `quirks` is an empty list) raises it
+   * too: there is no kind to cycle through, and an empty list is never read as the default.
+   */
   SYNTH_EMPTY_POOL: "SYNTH_EMPTY_POOL",
   /** A `defineSynthProfile` spec was not usable (a missing or blank `name`). Fatal. */
   SYNTH_INVALID_PROFILE: "SYNTH_INVALID_PROFILE",
@@ -92,7 +96,21 @@ var SYNTH_FATAL_CODES = Object.freeze({
    * apart without matching message text. Fatal, and raised **before** anything is generated: a
    * mislabelled artifact is worse than no artifact.
    */
-  SYNTH_PROFILE_NOT_GENERATED: "SYNTH_PROFILE_NOT_GENERATED"
+  SYNTH_PROFILE_NOT_GENERATED: "SYNTH_PROFILE_NOT_GENERATED",
+  /**
+   * The sibling parser a generator builds through is not installed. Raised on the first call that
+   * needs it, by both builds, only when the missing package is the parser itself: a missing
+   * dependency of an installed parser is thrown as Node.js raised it. The error carries the parser's
+   * package name on `peer`, a message from {@link SYNTH_PEER_MESSAGES} that names its install
+   * command, and the error Node.js raised on `cause`.
+   */
+  SYNTH_PEER_NOT_INSTALLED: "SYNTH_PEER_NOT_INSTALLED",
+  /**
+   * An HL7 v2 `ACK` was asked for an inbound message that carries no MSH-10 message control id.
+   * MSA-2 must echo that id, and an acknowledgment that cannot be matched to the message it answers
+   * is not a fixture worth having, so nothing is generated.
+   */
+  SYNTH_ACK_UNCORRELATED: "SYNTH_ACK_UNCORRELATED"
 });
 var SYNTH_FATAL_MESSAGES = Object.freeze({
   SYNTH_UNSUPPORTED_FORMAT: "The requested format is not generable by this build. A generator has no byte fallback: it builds through a parser's own serializer or it refuses.",
@@ -105,18 +123,38 @@ var SYNTH_FATAL_MESSAGES = Object.freeze({
   SYNTH_EMPTY_POOL: "A value was drawn from an empty pool.",
   SYNTH_INVALID_PROFILE: "defineSynthProfile requires a non-empty string name.",
   SYNTH_UNSUPPORTED_KIND: "The requested kind, document type, corpus mix entry, variant or profile is not one this generator supports. The supported set is the exported union for that option.",
-  SYNTH_PROFILE_NOT_GENERATED: "The requested profile is published by the adopted implementation guide, and this build does not generate it. The coverage surface reports, per adopted profile, whether it is generated."
+  SYNTH_PROFILE_NOT_GENERATED: "The requested profile is published by the adopted implementation guide, and this build does not generate it. The coverage surface reports, per adopted profile, whether it is generated.",
+  SYNTH_PEER_NOT_INSTALLED: "A sibling @cosyte parser this generator builds through is not installed. Install it beside @cosyte/synth.",
+  SYNTH_ACK_UNCORRELATED: (
+    // Stryker disable next-line all: a module-level table runs once, at import; the docs test holds it.
+    "The inbound message has no MSH-10 control id for an ACK to echo in MSA-2."
+  )
+});
+var SYNTH_PEER_MESSAGES = Object.freeze({
+  "@cosyte/hl7": "@cosyte/hl7 is not installed, and this generator builds through it. Install it beside @cosyte/synth: npm install @cosyte/hl7",
+  "@cosyte/fhir": "@cosyte/fhir is not installed, and this generator builds through it. Install it beside @cosyte/synth: npm install @cosyte/fhir",
+  "@cosyte/ccda": "@cosyte/ccda is not installed, and this generator builds through it. Install it beside @cosyte/synth: npm install @cosyte/ccda",
+  "@cosyte/x12": "@cosyte/x12 is not installed, and this generator builds through it. Install it beside @cosyte/synth: npm install @cosyte/x12",
+  "@cosyte/ncpdp": "@cosyte/ncpdp is not installed, and this generator builds through it. Install it beside @cosyte/synth: npm install @cosyte/ncpdp",
+  "@cosyte/astm": "@cosyte/astm is not installed, and this generator builds through it. Install it beside @cosyte/synth: npm install @cosyte/astm",
+  "@cosyte/deid": "@cosyte/deid is not installed, and this generator builds through it. Install it beside @cosyte/synth: npm install @cosyte/deid"
 });
 var SynthError = class extends Error {
   /** The stable fatal code. */
   code;
   /**
    * @param code - The stable {@link SynthFatalCode}. The message comes from the frozen registry.
+   * @param options - The error that caused this one, and for a missing parser its package.
    */
-  constructor(code) {
-    super(SYNTH_FATAL_MESSAGES[code]);
+  constructor(code, options = {}) {
+    const peer = code === SYNTH_FATAL_CODES.SYNTH_PEER_NOT_INSTALLED ? options.peer : void 0;
+    super(
+      peer === void 0 ? SYNTH_FATAL_MESSAGES[code] : SYNTH_PEER_MESSAGES[peer],
+      "cause" in options ? { cause: options.cause } : void 0
+    );
     this.name = "SynthError";
     this.code = code;
+    if (peer !== void 0) Object.defineProperty(this, "peer", { value: peer, enumerable: true });
   }
 };
 
@@ -210,7 +248,7 @@ function luhnMod10(digits) {
     if (d < 0 || d > 9) continue;
     if (double) {
       d *= 2;
-      if (d > 9) d -= 9;
+      if (d >= 10) d -= 9;
     }
     sum += d;
     double = !double;
@@ -307,7 +345,7 @@ var SYNTHETIC_CITY_NAMES = Object.freeze([
 ]);
 
 // src/safe/providers.ts
-function ssn(rng, block = "never-issued") {
+function ssn(rng, block) {
   if (block === "advertising") {
     return `987-00-432${String(rng.int(0, 9))}`;
   }
@@ -434,6 +472,63 @@ var US_STATES = Object.freeze([
   "WY"
 ]);
 
+// src/safe/animal-code.ts
+var ANIMAL_CODE_SYSTEM = "99COSYTE";
+function animalCode(value, text) {
+  return Object.freeze({ code: value, text, system: ANIMAL_CODE_SYSTEM });
+}
+function animalSpecies(value, text, breeds) {
+  return Object.freeze({ ...animalCode(value, text), breeds: Object.freeze([...breeds]) });
+}
+
+// src/safe/animal.ts
+var SYNTHETIC_ANIMAL_SPECIES = Object.freeze([
+  animalSpecies("DOG", "Dog", [
+    animalCode("DOG-LAB", "Labrador Retriever"),
+    animalCode("DOG-BGL", "Beagle"),
+    animalCode("DOG-MIX", "Mixed breed dog")
+  ]),
+  animalSpecies("CAT", "Cat", [animalCode("CAT-DSH", "Domestic Shorthair"), animalCode("CAT-SIA", "Siamese")]),
+  animalSpecies("HORSE", "Horse", [animalCode("HRS-QTR", "Quarter Horse"), animalCode("HRS-TB", "Thoroughbred")]),
+  animalSpecies("CATTLE", "Cattle", [animalCode("CTL-HOL", "Holstein"), animalCode("CTL-ANG", "Angus")])
+]);
+var SYNTHETIC_PET_NAMES = Object.freeze([
+  "Fixturepaw",
+  "Mockwhisker",
+  "Stubtail",
+  "Seedpup",
+  "Testbiscuit",
+  "Placepurr",
+  "Synthfur",
+  "Dummymane",
+  "Examplehoof",
+  "Fauxfluff",
+  "Samplesnout",
+  "Voidwag"
+]);
+var MICROCHIP_TEST_PREFIX = "999";
+function petName(rng) {
+  return rng.pick(SYNTHETIC_PET_NAMES);
+}
+function animalBreed(rng) {
+  const picked = rng.pick(SYNTHETIC_ANIMAL_SPECIES);
+  const { breeds, ...bare } = picked;
+  return { species: Object.freeze(bare), breed: rng.pick(breeds) };
+}
+function microchip(rng) {
+  return `${MICROCHIP_TEST_PREFIX}${rng.digits(12)}`;
+}
+function animalBirthDate(rng, onDate) {
+  const year = Number(onDate.slice(0, 4));
+  const month = Number(onDate.slice(4, 6)) - 1;
+  const day = Number(onDate.slice(6, 8));
+  const latest = Date.UTC(year, month, day);
+  const earliest = Date.UTC(year - 20, month, day);
+  const span = Math.round((latest - earliest) / 864e5);
+  const born = new Date(latest - rng.int(0, span) * 864e5);
+  return born.toISOString().slice(0, 10).replace(/-/g, "");
+}
+
 // src/safe/index.ts
 var safe = Object.freeze({
   ssn,
@@ -447,25 +542,54 @@ var safe = Object.freeze({
   address,
   dateYmd,
   npi,
-  dea
+  dea,
+  petName,
+  animalBreed,
+  microchip,
+  animalBirthDate
 });
 function defaultHost() {
   if (typeof undefined !== "function") return { require: __require, resolve: void 0 };
   return { require: module$1.createRequire((typeof document === 'undefined' ? require('u' + 'rl').pathToFileURL(__filename).href : (_documentCurrentScript && _documentCurrentScript.tagName.toUpperCase() === 'SCRIPT' && _documentCurrentScript.src || new URL('index.cjs', document.baseURI).href))), resolve: (s) => undefined(s) };
 }
+function isDenoResolveRefusal(error) {
+  return error instanceof TypeError && !("code" in error) && error.message === "Invalid arguments";
+}
 function isRequireEsmRefusal(error) {
   return error?.code === "ERR_REQUIRE_ESM";
 }
+function peerPackage(specifier) {
+  const name2 = specifier.split("/").slice(0, 2).join("/");
+  return Object.hasOwn(SYNTH_PEER_MESSAGES, name2) ? name2 : void 0;
+}
+function isPeerNotFound(error, specifier, peer) {
+  const { code, message } = error ?? {};
+  if (typeof message !== "string") return false;
+  if (code === "ERR_MODULE_NOT_FOUND") return message.startsWith(`Cannot find package '${peer}'`);
+  if (code === "MODULE_NOT_FOUND") return message.startsWith(`Cannot find module '${specifier}'`);
+  return false;
+}
 function loadPeer(specifier, host) {
+  try {
+    return loadFrom(specifier, host);
+  } catch (error) {
+    const peer = peerPackage(specifier);
+    if (peer === void 0 || !isPeerNotFound(error, specifier, peer)) throw error;
+    throw new SynthError(SYNTH_FATAL_CODES.SYNTH_PEER_NOT_INSTALLED, { peer, cause: error });
+  }
+}
+function loadFrom(specifier, host) {
   if (host.resolve === void 0) return host.require(specifier);
-  let entry;
+  let url$1;
   try {
-    entry = url.fileURLToPath(host.resolve(specifier));
-  } catch {
+    url$1 = host.resolve(specifier);
+  } catch (error) {
+    if (!isDenoResolveRefusal(error)) throw error;
     return host.require(specifier);
   }
+  if (!url$1.startsWith("file:")) return host.require(specifier);
   try {
-    return host.require(entry);
+    return host.require(url.fileURLToPath(url$1));
   } catch (error) {
     if (!isRequireEsmRefusal(error)) throw error;
     return host.require(specifier);
@@ -497,6 +621,20 @@ function seededTimestamp(rng) {
   const ss = String(rng.int(0, 59)).padStart(2, "0");
   return `${date}${hh}${mm}${ss}`;
 }
+function shiftTimestamp(timestamp, seconds) {
+  const at = new Date(
+    Date.UTC(
+      Number(timestamp.slice(0, 4)),
+      Number(timestamp.slice(4, 6)) - 1,
+      Number(timestamp.slice(6, 8)),
+      Number(timestamp.slice(8, 10)),
+      Number(timestamp.slice(10, 12)),
+      Number(timestamp.slice(12, 14)) + seconds
+    )
+  );
+  const pad = (n, width = 2) => String(n).padStart(width, "0");
+  return pad(at.getUTCFullYear(), 4) + pad(at.getUTCMonth() + 1) + pad(at.getUTCDate()) + pad(at.getUTCHours()) + pad(at.getUTCMinutes()) + pad(at.getUTCSeconds());
+}
 function mshScaffold(rng, type) {
   const timestamp = seededTimestamp(rng);
   const controlId = `SYNTH${rng.digits(10)}`;
@@ -567,6 +705,107 @@ function pidSegment(id) {
     // PID-19 SSN (digits)
   ];
 }
+function hl7Subjects() {
+  return ["person", "animal"];
+}
+var MICROCHIP_IDENTIFIER_TYPE = "MCN";
+var OWNER_RELATIONSHIP = Object.freeze({ code: "OWN", text: "Owner", system: "HL70063" });
+function animalIdentity(rng, onDate) {
+  const person = safe.name(rng);
+  const petName2 = safe.petName(rng);
+  const record = safe.identifier(rng, "MR");
+  const microchip2 = safe.microchip(rng);
+  const { species, breed } = safe.animalBreed(rng);
+  const dob = safe.animalBirthDate(rng, onDate);
+  const sex = rng.pick(["M", "F"]);
+  const address2 = safe.address(rng);
+  const phone2 = safe.phone(rng);
+  return {
+    petName: petName2,
+    record,
+    microchip: microchip2,
+    species,
+    breed,
+    dob,
+    sex,
+    owner: { person, address: address2, phone: phone2 }
+  };
+}
+function codedField(value) {
+  return componentsField([value.code, value.text, value.system]);
+}
+function animalPidSegment(id) {
+  const authority = id.record.assigningAuthority;
+  const cx = (value, type) => ({
+    components: [value, "", "", authority, type].map((c) => ({ subcomponents: [c] }))
+  });
+  const identifiers = {
+    repetitions: [
+      cx(id.record.value, id.record.typeCode),
+      cx(id.microchip, MICROCHIP_IDENTIFIER_TYPE)
+    ],
+    isNull: false
+  };
+  const { person, address: address2, phone: phone2 } = id.owner;
+  return [
+    "1",
+    // PID-1 set id
+    "",
+    // PID-2
+    identifiers,
+    // PID-3 CX: record number, then microchip
+    "",
+    // PID-4
+    componentsField([person.family, id.petName]),
+    // PID-5 XPN: owner family, pet name
+    "",
+    // PID-6
+    id.dob,
+    // PID-7 DOB
+    id.sex,
+    // PID-8 sex
+    "",
+    // PID-9
+    "",
+    // PID-10
+    componentsField([address2.street, "", address2.city, address2.state, address2.zip]),
+    // PID-11 XAD
+    "",
+    // PID-12
+    phone2,
+    // PID-13 phone
+    ...Array(21).fill(""),
+    // PID-14 to PID-34
+    codedField(id.species),
+    // PID-35 species code (CE)
+    codedField(id.breed)
+    // PID-36 breed code (CE)
+  ];
+}
+function ownerNk1Segment(id) {
+  const { person, address: address2, phone: phone2 } = id.owner;
+  return [
+    "1",
+    // NK1-1 set id
+    componentsField([person.family, person.given]),
+    // NK1-2 name
+    codedField(OWNER_RELATIONSHIP),
+    // NK1-3 relationship (CE)
+    componentsField([address2.street, "", address2.city, address2.state, address2.zip]),
+    // NK1-4
+    phone2
+    // NK1-5 phone
+  ];
+}
+function addSubject(message, rng, subject, timestamp) {
+  if (subject === "person") {
+    message.addSegment("PID", pidSegment(patientIdentity(rng)));
+    return;
+  }
+  const animal = animalIdentity(rng, timestamp);
+  message.addSegment("PID", animalPidSegment(animal));
+  message.addSegment("NK1", ownerNk1Segment(animal));
+}
 
 // src/select.ts
 function resolveKind(allowed, requested) {
@@ -576,25 +815,84 @@ function resolveKind(allowed, requested) {
 }
 
 // src/hl7/adt.ts
-var ADT_TRIGGERS = Object.freeze(["A01", "A04", "A08"]);
+function adtTriggers() {
+  return ["A01", "A04", "A08", "A02", "A03", "A11", "A13", "A28", "A31"];
+}
+function structureOf(trigger) {
+  switch (trigger) {
+    case "A02":
+      return "ADT_A02";
+    case "A03":
+      return "ADT_A03";
+    case "A11":
+      return "ADT_A09";
+    case "A13":
+      return "ADT_A01";
+    case "A28":
+    case "A31":
+      return "ADT_A05";
+  }
+}
+function ward(room) {
+  return componentsField(["SYNTHWARD", String(room).padStart(3, "0"), "01"]);
+}
+function location(rng) {
+  return ward(rng.int(1, 999));
+}
+function admittedBefore(rng, timestamp) {
+  return shiftTimestamp(timestamp, -rng.int(3600, 14 * 86400));
+}
 function generateAdt(options = {}) {
   const seed = options.seed ?? 0;
-  const trigger = resolveKind(ADT_TRIGGERS, options.trigger ?? "A01");
+  const trigger = resolveKind(adtTriggers(), options.trigger ?? "A01");
+  const subject = resolveKind(hl7Subjects(), options.subject ?? "person");
   const rng = createRng(seed);
-  const { message, timestamp } = mshScaffold(rng, `ADT^${trigger}`);
+  if (trigger === "A01" || trigger === "A04" || trigger === "A08") {
+    const { message: message2, timestamp: timestamp2 } = mshScaffold(rng, `ADT^${trigger}`);
+    message2.addSegment("EVN", [trigger, timestamp2]);
+    addSubject(message2, rng, subject, timestamp2);
+    const patientClass = rng.pick(["I", "O", "E"]);
+    message2.addSegment("PV1", [
+      "1",
+      // PV1-1 set id
+      patientClass,
+      // PV1-2 patient class
+      location(rng)
+      // PV1-3 PL
+    ]);
+    return message2;
+  }
+  const { message, timestamp } = mshScaffold(rng, `ADT^${trigger}^${structureOf(trigger)}`);
   message.addSegment("EVN", [trigger, timestamp]);
-  message.addSegment("PID", pidSegment(patientIdentity(rng)));
-  const patientClass = rng.pick(["I", "O", "E"]);
-  message.addSegment("PV1", [
-    "1",
-    // PV1-1 set id
-    patientClass,
-    // PV1-2 patient class
-    componentsField(["SYNTHWARD", String(rng.int(1, 999)).padStart(3, "0"), "01"])
-    // PV1-3 PL
-  ]);
+  addSubject(message, rng, subject, timestamp);
+  message.addSegment("PV1", visit(rng, trigger, timestamp));
   return message;
 }
+function visit(rng, trigger, timestamp) {
+  switch (trigger) {
+    case "A02": {
+      const room = rng.int(1, 998);
+      const priorRoom = room + rng.int(1, 999 - room);
+      return ["1", "I", ward(room), "", "", ward(priorRoom)];
+    }
+    case "A03": {
+      const patientClass = rng.pick(["I", "O", "E"]);
+      const where = location(rng);
+      const admitted = admittedBefore(rng, timestamp);
+      return ["1", patientClass, where, ...Array(40).fill(""), admitted, timestamp];
+    }
+    case "A11":
+      return ["1", rng.pick(["I", "O", "E"]), location(rng)];
+    case "A13": {
+      const where = location(rng);
+      const admitted = admittedBefore(rng, timestamp);
+      return ["1", "I", where, ...Array(40).fill(""), admitted];
+    }
+    case "A28":
+    case "A31":
+      return ["1", "N"];
+  }
+}
 
 // src/hl7/example-codes.ts
 var EXAMPLE_LAB_OBSERVATIONS = Object.freeze([
@@ -659,9 +957,10 @@ function obxSegment(rng, setId) {
 }
 function generateOru(options = {}) {
   const seed = options.seed ?? 0;
+  const subject = resolveKind(hl7Subjects(), options.subject ?? "person");
   const rng = createRng(seed);
-  const { message } = mshScaffold(rng, "ORU^R01");
-  message.addSegment("PID", pidSegment(patientIdentity(rng)));
+  const { message, timestamp } = mshScaffold(rng, "ORU^R01");
+  addSubject(message, rng, subject, timestamp);
   const service = rng.pick(EXAMPLE_ORDER_SERVICES);
   const placer = rng.digits(8);
   const filler = rng.digits(8);
@@ -852,18 +1151,206 @@ function generateVxu(options = {}) {
   return message;
 }
 
+// src/hl7/mdm.ts
+var DOCUMENT_TYPES = Object.freeze(["CN", "DS", "HP", "PN"]);
+var NOTE_LINES = Object.freeze([
+  "Synthetic test document for interface testing.",
+  "Synthetic note text: no real patient is described here.",
+  "Synthetic content generated from a seed."
+]);
+function generateMdm(options = {}) {
+  const seed = options.seed ?? 0;
+  const rng = createRng(seed);
+  const { message, timestamp } = mshScaffold(rng, "MDM^T02^MDM_T02");
+  message.addSegment("EVN", ["T02", timestamp]);
+  message.addSegment("PID", pidSegment(patientIdentity(rng)));
+  message.addSegment("PV1", ["1", rng.pick(["I", "O", "E"])]);
+  const documentType = rng.pick(DOCUMENT_TYPES);
+  const documentNumber = `SYNTHDOC${rng.digits(10)}`;
+  message.addSegment("TXA", [
+    "1",
+    // TXA-1 set id
+    documentType,
+    // TXA-2 document type
+    "TX",
+    // TXA-3 document content presentation (text)
+    timestamp,
+    // TXA-4 activity date/time
+    ...Array(7).fill(""),
+    // TXA-5 to TXA-11
+    componentsField([documentNumber, "COSYTE-SYNTH"]),
+    // TXA-12 unique document number (EI)
+    ...Array(4).fill(""),
+    // TXA-13 to TXA-16
+    "DO"
+    // TXA-17 document completion status (documented)
+  ]);
+  const lines = rng.int(1, 3);
+  for (let i = 1; i <= lines; i += 1) {
+    message.addSegment("OBX", [
+      String(i),
+      // OBX-1 set id
+      "TX",
+      // OBX-2 value type
+      componentsField(["SYNTHNOTE", "Synthetic note", "99SYN"]),
+      // OBX-3 observation id (local)
+      "",
+      // OBX-4 sub-id
+      rng.pick(NOTE_LINES),
+      // OBX-5 the document text
+      ...Array(5).fill(""),
+      // OBX-6 to OBX-10
+      "F"
+      // OBX-11 result status (final)
+    ]);
+  }
+  return message;
+}
+
+// src/hl7/dft.ts
+function charges() {
+  return [
+    { code: "SYNTHCHG01", text: "Synthetic office visit charge" },
+    { code: "SYNTHCHG02", text: "Synthetic laboratory charge" },
+    { code: "SYNTHCHG03", text: "Synthetic imaging charge" },
+    { code: "SYNTHCHG04", text: "Synthetic supply charge" }
+  ];
+}
+function generateDft(options = {}) {
+  const seed = options.seed ?? 0;
+  const rng = createRng(seed);
+  const { message, timestamp } = mshScaffold(rng, "DFT^P03^DFT_P03");
+  message.addSegment("EVN", ["P03", timestamp]);
+  message.addSegment("PID", pidSegment(patientIdentity(rng)));
+  message.addSegment("PV1", ["1", rng.pick(["I", "O", "E"])]);
+  const transactionId = `SYNTHTXN${rng.digits(8)}`;
+  const charge = rng.pick(charges());
+  const quantity = String(rng.int(1, 3));
+  message.addSegment("FT1", [
+    "1",
+    // FT1-1 set id
+    transactionId,
+    // FT1-2 transaction id
+    "",
+    // FT1-3 transaction batch id
+    timestamp,
+    // FT1-4 transaction date
+    "",
+    // FT1-5 transaction posting date
+    "CG",
+    // FT1-6 transaction type (charge)
+    componentsField([charge.code, charge.text, "99SYN"]),
+    // FT1-7 transaction code (local)
+    "",
+    // FT1-8 transaction description
+    "",
+    // FT1-9 transaction description, alternate
+    quantity
+    // FT1-10 transaction quantity
+  ]);
+  return message;
+}
+
+// src/hl7/oml.ts
+function generateOml(options = {}) {
+  const seed = options.seed ?? 0;
+  const rng = createRng(seed);
+  const { message } = mshScaffold(rng, "OML^O21^OML_O21");
+  message.addSegment("PID", pidSegment(patientIdentity(rng)));
+  const service = rng.pick(EXAMPLE_ORDER_SERVICES);
+  const placer = rng.digits(8);
+  const filler = rng.digits(8);
+  const orderedAt = seededTimestamp(rng);
+  message.addSegment("ORC", [
+    "NW",
+    // ORC-1 order control (new order)
+    placer,
+    // ORC-2 placer order number
+    filler,
+    // ORC-3 filler order number
+    ...Array(5).fill(""),
+    // ORC-4 to ORC-8
+    orderedAt
+    // ORC-9 date/time of transaction
+  ]);
+  message.addSegment("OBR", [
+    "1",
+    // OBR-1 set id
+    placer,
+    // OBR-2 placer order number (matches ORC)
+    filler,
+    // OBR-3 filler order number (matches ORC)
+    componentsField([service.code, service.text, service.system])
+    // OBR-4 universal service id
+  ]);
+  return message;
+}
+
+// src/hl7/ack.ts
+function generateAck(options = {}) {
+  const seed = options.seed ?? 0;
+  const allowed = ["AA", "AE", "AR"];
+  const code = resolveKind(allowed, options.code ?? "AA");
+  const inbound = options.inbound ?? generateAdt({ seed });
+  const inboundControlId = inbound.get("MSH.10") ?? "";
+  if (inboundControlId === "") throw new SynthError(SYNTH_FATAL_CODES.SYNTH_ACK_UNCORRELATED);
+  const rng = createRng(seed);
+  const delaySeconds = rng.int(1, 59);
+  const controlId = `SYNTHACK${rng.digits(10)}`;
+  const inboundTime = String(inbound.get("MSH.7"));
+  const timestamp = /^\d{14}$/.test(inboundTime) ? shiftTimestamp(inboundTime, delaySeconds) : seededTimestamp(rng);
+  const trigger = inbound.get("MSH.9.2") ?? "";
+  const message = hl7Peer().buildMessage({
+    type: trigger === "" ? "ACK" : `ACK^${trigger}^ACK`,
+    sendingApp: inbound.get("MSH.5") ?? "",
+    sendingFacility: inbound.get("MSH.6") ?? "",
+    receivingApp: inbound.get("MSH.3") ?? "",
+    receivingFacility: inbound.get("MSH.4") ?? "",
+    controlId,
+    timestamp,
+    version: inbound.get("MSH.12") ?? "2.5",
+    // MSH-11 processing ID `T` (HL7 table 0103: training): an acknowledgment of test data is test
+    // data, so it never echoes a `P` from the inbound message.
+    processingId: "T"
+  });
+  message.addSegment("MSA", [code, inboundControlId]);
+  if (code !== "AA") {
+    message.addSegment("ERR", [
+      "",
+      // ERR-1 error code and location (backward compatible only)
+      "",
+      // ERR-2 error location
+      componentsField(["207", "Application internal error", "HL70357"]),
+      // ERR-3 HL7 error code
+      "E"
+      // ERR-4 severity (error)
+    ]);
+  }
+  return message;
+}
+
 // src/hl7/index.ts
-var ALL_KINDS = Object.freeze([
+var HL7_MESSAGE_KINDS = Object.freeze([
   "ADT^A01",
   "ADT^A04",
   "ADT^A08",
   "ORU^R01",
   "ORM^O01",
   "SIU^S12",
-  "VXU^V04"
+  "VXU^V04",
+  "ACK",
+  "ADT^A02",
+  "ADT^A03",
+  "ADT^A11",
+  "ADT^A13",
+  "ADT^A28",
+  "ADT^A31",
+  "MDM^T02",
+  "DFT^P03",
+  "OML^O21"
 ]);
 function generateHl7(kind, seed) {
-  switch (resolveKind(ALL_KINDS, kind)) {
+  switch (resolveKind(HL7_MESSAGE_KINDS, kind)) {
     case "ADT^A01":
       return generateAdt({ seed, trigger: "A01" });
     case "ADT^A04":
@@ -878,6 +1365,26 @@ function generateHl7(kind, seed) {
       return generateSiu({ seed });
     case "VXU^V04":
       return generateVxu({ seed });
+    case "ACK":
+      return generateAck({ seed });
+    case "ADT^A02":
+      return generateAdt({ seed, trigger: "A02" });
+    case "ADT^A03":
+      return generateAdt({ seed, trigger: "A03" });
+    case "ADT^A11":
+      return generateAdt({ seed, trigger: "A11" });
+    case "ADT^A13":
+      return generateAdt({ seed, trigger: "A13" });
+    case "ADT^A28":
+      return generateAdt({ seed, trigger: "A28" });
+    case "ADT^A31":
+      return generateAdt({ seed, trigger: "A31" });
+    case "MDM^T02":
+      return generateMdm({ seed });
+    case "DFT^P03":
+      return generateDft({ seed });
+    case "OML^O21":
+      return generateOml({ seed });
   }
 }