@imranq2/fhirpatientsummary 1.0.14 → 1.0.16

package/README.md

@@ -2,6 +2,8 @@
 
 This project provides utilities to generate patient summaries from FHIR Bundles, including narrative generation and section extraction, following the International Patient Summary (IPS) specification.
 
+Detailed explanation of content of each section of IPS is [here](./sections.md)
+
 ## Installation
 
 Clone the repository and install dependencies:

package/dist/index.cjs

@@ -103,6 +103,11 @@ var SOCIAL_HISTORY_LOINC_CODES = {
   "72166-2": "Tobacco Use",
   "74013-4": "Alcohol Use"
 };
+var BLOOD_PRESSURE_LOINC_CODES = {
+  OBSERVATION: "85354-9",
+  SYSTOLIC: "8480-6",
+  DIASTOLIC: "8462-4"
+};
 
 // src/structures/ips_section_resource_map.ts
 var IPSSectionResourceMap = {
@@ -126,9 +131,7 @@ var IPSSectionResourceMap = {
   ["AdvanceDirectivesSection" /* ADVANCE_DIRECTIVES */]: ["Consent"]
 };
 var IPSSectionResourceFilters = {
-  // Only include active allergies
-  ["AllergyIntoleranceSection" /* ALLERGIES */]: (resource) => resource.resourceType === "AllergyIntolerance" && resource.clinicalStatus?.coding?.some((c) => typeof c.code === "string"),
-  // Only include active problems/conditions
+  // Only include active conditions
   ["ProblemSection" /* PROBLEMS */]: (resource) => resource.resourceType === "Condition" && resource.clinicalStatus?.coding?.some((c) => !["inactive", "resolved"].includes(c.code)),
   // Only include completed immunizations
   ["ImmunizationSection" /* IMMUNIZATIONS */]: (resource) => resource.resourceType === "Immunization" && resource.status === "completed" || resource.resourceType === "Organization",
@@ -138,12 +141,12 @@ var IPSSectionResourceFilters = {
   ["ResultsSection" /* DIAGNOSTIC_REPORTS */]: (resource) => ["DiagnosticReport", "Observation"].includes(resource.resourceType) && resource.status === "final",
   // Only include completed procedures
   ["HistoryOfProceduresSection" /* PROCEDURES */]: (resource) => resource.resourceType === "Procedure" && resource.status === "completed",
-  // Only include social history Observations (category.coding contains 'social-history')
+  // Only include social history Observations
   ["SocialHistorySection" /* SOCIAL_HISTORY */]: (resource) => resource.resourceType === "Observation" && resource.code?.coding?.some((c) => Object.keys(SOCIAL_HISTORY_LOINC_CODES).includes(c.code)),
-  // Only include pregnancy history Observations (category.coding contains 'pregnancy')
+  // Only include pregnancy history Observations
   ["HistoryOfPregnancySection" /* PREGNANCY_HISTORY */]: (resource) => resource.resourceType === "Observation" && (resource.code?.coding?.some((c) => Object.keys(PREGNANCY_LOINC_CODES.PREGNANCY_STATUS).includes(c.code)) || resource.valueCodeableConcept?.coding?.some((c) => Object.keys(PREGNANCY_LOINC_CODES.PREGNANCY_OUTCOME).includes(c.code))),
-  // Only include active functional status Conditions or ClinicalImpressions
-  ["FunctionalStatusSection" /* FUNCTIONAL_STATUS */]: (resource) => resource.resourceType === "Condition" && resource.clinicalStatus?.coding?.some((c) => typeof c.code === "string") || resource.resourceType === "ClinicalImpression" && resource.status === "completed",
+  // Only include Conditions or completed ClinicalImpressions
+  ["FunctionalStatusSection" /* FUNCTIONAL_STATUS */]: (resource) => resource.resourceType === "Condition" || resource.resourceType === "ClinicalImpression" && resource.status === "completed",
   // Only include resolved medical history Conditions
   ["HistoryOfPastIllnessSection" /* MEDICAL_HISTORY */]: (resource) => resource.resourceType === "Condition" && resource.clinicalStatus?.coding?.some((c) => ["inactive", "resolved"].includes(c.code)),
   // Only include active care plans
@@ -532,6 +535,28 @@ var TemplateUtilities = class {
     return "";
   }
   extractObservationValue(observation) {
+    if (observation.code && observation.code.coding && "component" in observation && Array.isArray(observation.component)) {
+      const bpCode = observation.code.coding.find(
+        (c) => c.code === BLOOD_PRESSURE_LOINC_CODES.OBSERVATION
+      );
+      if (bpCode) {
+        const systolicComponent = observation.component?.find(
+          (c) => c.code?.coding?.some(
+            (cc) => cc.code === BLOOD_PRESSURE_LOINC_CODES.SYSTOLIC
+          )
+        );
+        const diastolicComponent = observation.component?.find(
+          (c) => c.code?.coding?.some(
+            (cc) => cc.code === BLOOD_PRESSURE_LOINC_CODES.DIASTOLIC
+          )
+        );
+        if (systolicComponent && diastolicComponent) {
+          const systolic = this.extractObservationValue(systolicComponent);
+          const diastolic = this.extractObservationValue(diastolicComponent);
+          return `${systolic}/${diastolic}`;
+        }
+      }
+    }
     const valueFields = [
       "valueString",
       "valueInteger",
@@ -854,7 +879,9 @@ var PatientTemplate = class _PatientTemplate {
     patient.name.forEach((name) => {
       if (name.use !== "old") {
         const nameText = name.text || ((name.given || []).join(" ") + " " + (name.family || "")).trim();
-        uniqueNames.add(nameText);
+        if (nameText) {
+          uniqueNames.add(nameText);
+        }
       }
     });
     return Array.from(uniqueNames).map((nameText) => `<ul><li>${nameText}</li></ul>`).join("");
@@ -884,9 +911,10 @@ var PatientTemplate = class _PatientTemplate {
       return "";
     }
     const systemPriority = ["email", "phone", "pager", "sms", "fax", "url", "other"];
+    const numberSystems = ["phone", "pager", "sms", "fax"];
     const telecomBySystem = /* @__PURE__ */ new Map();
     patient.telecom.forEach((telecom) => {
-      if (telecom.system && telecom.value) {
+      if (telecom.system && telecom.value && telecom.use !== "old") {
         const system = telecom.system.toLowerCase();
         if (!telecomBySystem.has(system)) {
           telecomBySystem.set(system, /* @__PURE__ */ new Set());
@@ -894,6 +922,29 @@ var PatientTemplate = class _PatientTemplate {
         telecomBySystem.get(system).add(telecom.value);
       }
     });
+    for (const system of numberSystems) {
+      const currentNumbers = Array.from(telecomBySystem.get(system) || []);
+      if (currentNumbers.length <= 1) continue;
+      const numbersWithCleaned = currentNumbers.map((num) => ({
+        original: num,
+        cleaned: num.replace(/\D/g, "")
+      }));
+      const toRemove = /* @__PURE__ */ new Set();
+      for (let i = 0; i < numbersWithCleaned.length; i++) {
+        for (let j = i + 1; j < numbersWithCleaned.length; j++) {
+          const num1 = numbersWithCleaned[i];
+          const num2 = numbersWithCleaned[j];
+          if (num1.cleaned.endsWith(num2.cleaned)) {
+            toRemove.add(num2.original);
+          } else if (num2.cleaned.endsWith(num1.cleaned)) {
+            toRemove.add(num1.original);
+          }
+        }
+      }
+      toRemove.forEach((numberToRemove) => {
+        telecomBySystem.get(system)?.delete(numberToRemove);
+      });
+    }
     return Array.from(telecomBySystem.entries()).sort(([systemA], [systemB]) => {
       const priorityA = systemPriority.indexOf(systemA);
       const priorityB = systemPriority.indexOf(systemB);
@@ -920,7 +971,24 @@ var PatientTemplate = class _PatientTemplate {
     }
     const uniqueAddresses = /* @__PURE__ */ new Set();
     patient.address.forEach((address) => {
-      const addressText = address.text || ((address.line || []).join(", ") + ", " + (address.city || "") + ", " + (address.country || "")).trim();
+      if (address.use === "old") {
+        return;
+      }
+      const addressArray = [];
+      if (address.text) {
+        addressArray.push(address.text);
+      } else {
+        if (address.line) {
+          addressArray.push(...address.line);
+        }
+        if (address.city) {
+          addressArray.push(address.city);
+        }
+        if (address.country) {
+          addressArray.push(address.country);
+        }
+      }
+      const addressText = addressArray.join(", ").trim();
       if (addressText) {
         uniqueAddresses.add(addressText);
       }
@@ -951,12 +1019,18 @@ var PatientTemplate = class _PatientTemplate {
     if (!patient.communication || patient.communication.length === 0) {
       return "";
     }
-    return patient.communication.map((comm) => {
-      if (!comm.language) return "";
+    const uniqueLanguages = /* @__PURE__ */ new Set();
+    const preferredLanguages = /* @__PURE__ */ new Set();
+    patient.communication.forEach((comm) => {
       const language = templateUtilities.codeableConcept(comm.language);
-      const preferred = comm.preferred ? " (preferred)" : "";
-      return `<ul><li>${language}${preferred}</li></ul>`;
-    }).join("");
+      if (language) {
+        if (comm.preferred) {
+          preferredLanguages.add(language);
+        }
+        uniqueLanguages.add(language);
+      }
+    });
+    return Array.from(uniqueLanguages).map((language) => `<ul><li>${language}${preferredLanguages.has(language) ? " (preferred)" : ""}</li></ul>`).join("");
   }
   /**
    * Capitalizes first letter of a string
@@ -993,8 +1067,8 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
     if (resource.entry && Array.isArray(resource.entry)) {
       for (const entry of resource.entry) {
         const allergy = entry.resource;
-        const status = allergy.clinicalStatus?.coding?.[0]?.code || "";
-        if (status === "inactive" || status === "resolved") {
+        const isResolved = allergy.clinicalStatus?.coding?.some((c) => ["inactive", "resolved"].includes(c.code));
+        if (isResolved) {
           resolvedAllergies.push(allergy);
         } else {
           activeAllergies.push(allergy);
@@ -1022,7 +1096,6 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
               <th>Status</th>
               <th>Category</th>
               <th>Reaction</th>
-              <th>Severity</th>
               <th>Onset Date</th>
               <th>Comments</th>
             </tr>
@@ -1050,7 +1123,6 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
               <th>Status</th>
               <th>Category</th>
               <th>Reaction</th>
-              <th>Severity</th>
               <th>Onset Date</th>
               <th>Comments</th>
               <th>Resolved Date</th>
@@ -1088,7 +1160,6 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
           <td class="Status">${templateUtilities.codeableConcept(allergy.clinicalStatus) || "-"}</td>
           <td class="Category">${templateUtilities.safeConcat(allergy.category) || "-"}</td>
           <td class="Reaction">${templateUtilities.concatReactionManifestation(allergy.reaction) || "-"}</td>
-          <td class="Severity">${templateUtilities.safeConcat(allergy.reaction, "severity") || "-"}</td>
           <td class="OnsetDate">${templateUtilities.renderTime(allergy.onsetDateTime, timezone) || "-"}</td>
           <td class="Comments">${templateUtilities.renderNotes(allergy.note, timezone, { styled: true, warning: true })}</td>`;
       if (includeResolved) {
@@ -1238,11 +1309,11 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
     };
     if (allActiveMedications.length > 0) {
       sortMedications(allActiveMedications);
-      html += this.renderCombinedMedications(templateUtilities, allActiveMedications, "Active Medications");
+      html += this.renderCombinedMedications(templateUtilities, allActiveMedications, true);
     }
     if (allInactiveMedications.length > 0) {
       sortMedications(allInactiveMedications);
-      html += this.renderCombinedMedications(templateUtilities, allInactiveMedications, "Inactive Medications");
+      html += this.renderCombinedMedications(templateUtilities, allInactiveMedications, false);
     }
     return html;
   }
@@ -1283,9 +1354,9 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
    * @param sectionTitle - Title for the section
    * @returns HTML string for rendering
    */
-  static renderCombinedMedications(templateUtilities, medications, sectionTitle) {
+  static renderCombinedMedications(templateUtilities, medications, isActiveSection) {
     let html = `
-    <h3>${sectionTitle}</h3>
+    <h3>${isActiveSection ? "Active Medications" : "Inactive Medications"}</h3>
       <table>
         <thead>
           <tr>
@@ -1294,8 +1365,8 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
             <th>Sig</th>
             <th>Dispense Quantity</th>
             <th>Refills</th>
-            <th>Start Date</th>
-            <th>End Date</th>
+            <th>Start Date</th>${isActiveSection ? "" : `
+            <th>End Date</th>`}
             <th>Status</th>
           </tr>
         </thead>
@@ -1353,8 +1424,8 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
           <td>${sig}</td>
           <td>${dispenseQuantity}</td>
           <td>${refills}</td>
-          <td>${startDate}</td>
-          <td>${endDate}</td>
+          <td>${startDate}</td>${isActiveSection ? "" : `
+          <td>${endDate}</td>`}
           <td>${status}</td>
         </tr>`;
     }
@@ -1460,7 +1531,6 @@ var ProblemListTemplate = class _ProblemListTemplate {
           <thead>
             <tr>
               <th>Problem</th>
-              <th>Severity</th>
               <th>Onset Date</th>
               <th>Recorded Date</th>
               <th>Notes</th>
@@ -1470,7 +1540,6 @@ var ProblemListTemplate = class _ProblemListTemplate {
     for (const cond of activeConditions) {
       html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
           <td class="Name">${templateUtilities.codeableConcept(cond.code)}</td>
-          <td class="Severity">${templateUtilities.codeableConcept(cond.severity)}</td>
           <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
           <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
           <td class="Notes">${templateUtilities.renderNotes(cond.note, timezone)}</td>
@@ -1714,7 +1783,6 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
         <thead>
           <tr>
             <th>Report</th>
-            <th>Status</th>
             <th>Category</th>
             <th>Result</th>
             <th>Issued</th>
@@ -1729,7 +1797,6 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
       html += `
         <tr id="${templateUtilities.narrativeLinkId(report)}">
           <td>${templateUtilities.codeableConcept(report.code)}</td>
-          <td>${report.status || ""}</td>
           <td>${templateUtilities.firstFromCodeableConceptList(report.category)}</td>
           <td>${resultCount}</td>
           <td>${report.issued ? templateUtilities.renderTime(report.issued, timezone) : ""}</td>
@@ -1870,7 +1937,6 @@ var PastHistoryOfIllnessTemplate = class {
           <thead>
             <tr>
               <th>Problem</th>
-              <th>Severity</th>
               <th>Onset Date</th>
               <th>Recorded Date</th>
               <th>Resolved Date</th>
@@ -1881,7 +1947,6 @@ var PastHistoryOfIllnessTemplate = class {
     for (const cond of resolvedConditions) {
       html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
           <td class="Name">${templateUtilities.codeableConcept(cond.code)}</td>
-          <td class="Severity">${templateUtilities.codeableConcept(cond.severity)}</td>
           <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
           <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
           <td class="ResolvedDate">${templateUtilities.renderDate(cond.abatementDateTime)}</td>
@@ -1992,7 +2057,6 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
           <thead>
             <tr>
               <th>Problem</th>
-              <th>Severity</th>
               <th>Onset Date</th>
               <th>Recorded Date</th>
               <th>Notes</th>
@@ -2002,7 +2066,6 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
       for (const cond of activeConditions) {
         html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
           <td class="Name">${templateUtilities.codeableConcept(cond.code)}</td>
-          <td class="Severity">${templateUtilities.codeableConcept(cond.severity)}</td>
           <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
           <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
           <td class="Notes">${templateUtilities.renderNotes(cond.note, timezone, { styled: true, warning: true })}</td>

package/dist/index.js

@@ -75,6 +75,11 @@ var SOCIAL_HISTORY_LOINC_CODES = {
   "72166-2": "Tobacco Use",
   "74013-4": "Alcohol Use"
 };
+var BLOOD_PRESSURE_LOINC_CODES = {
+  OBSERVATION: "85354-9",
+  SYSTOLIC: "8480-6",
+  DIASTOLIC: "8462-4"
+};
 
 // src/structures/ips_section_resource_map.ts
 var IPSSectionResourceMap = {
@@ -98,9 +103,7 @@ var IPSSectionResourceMap = {
   ["AdvanceDirectivesSection" /* ADVANCE_DIRECTIVES */]: ["Consent"]
 };
 var IPSSectionResourceFilters = {
-  // Only include active allergies
-  ["AllergyIntoleranceSection" /* ALLERGIES */]: (resource) => resource.resourceType === "AllergyIntolerance" && resource.clinicalStatus?.coding?.some((c) => typeof c.code === "string"),
-  // Only include active problems/conditions
+  // Only include active conditions
   ["ProblemSection" /* PROBLEMS */]: (resource) => resource.resourceType === "Condition" && resource.clinicalStatus?.coding?.some((c) => !["inactive", "resolved"].includes(c.code)),
   // Only include completed immunizations
   ["ImmunizationSection" /* IMMUNIZATIONS */]: (resource) => resource.resourceType === "Immunization" && resource.status === "completed" || resource.resourceType === "Organization",
@@ -110,12 +113,12 @@ var IPSSectionResourceFilters = {
   ["ResultsSection" /* DIAGNOSTIC_REPORTS */]: (resource) => ["DiagnosticReport", "Observation"].includes(resource.resourceType) && resource.status === "final",
   // Only include completed procedures
   ["HistoryOfProceduresSection" /* PROCEDURES */]: (resource) => resource.resourceType === "Procedure" && resource.status === "completed",
-  // Only include social history Observations (category.coding contains 'social-history')
+  // Only include social history Observations
   ["SocialHistorySection" /* SOCIAL_HISTORY */]: (resource) => resource.resourceType === "Observation" && resource.code?.coding?.some((c) => Object.keys(SOCIAL_HISTORY_LOINC_CODES).includes(c.code)),
-  // Only include pregnancy history Observations (category.coding contains 'pregnancy')
+  // Only include pregnancy history Observations
   ["HistoryOfPregnancySection" /* PREGNANCY_HISTORY */]: (resource) => resource.resourceType === "Observation" && (resource.code?.coding?.some((c) => Object.keys(PREGNANCY_LOINC_CODES.PREGNANCY_STATUS).includes(c.code)) || resource.valueCodeableConcept?.coding?.some((c) => Object.keys(PREGNANCY_LOINC_CODES.PREGNANCY_OUTCOME).includes(c.code))),
-  // Only include active functional status Conditions or ClinicalImpressions
-  ["FunctionalStatusSection" /* FUNCTIONAL_STATUS */]: (resource) => resource.resourceType === "Condition" && resource.clinicalStatus?.coding?.some((c) => typeof c.code === "string") || resource.resourceType === "ClinicalImpression" && resource.status === "completed",
+  // Only include Conditions or completed ClinicalImpressions
+  ["FunctionalStatusSection" /* FUNCTIONAL_STATUS */]: (resource) => resource.resourceType === "Condition" || resource.resourceType === "ClinicalImpression" && resource.status === "completed",
   // Only include resolved medical history Conditions
   ["HistoryOfPastIllnessSection" /* MEDICAL_HISTORY */]: (resource) => resource.resourceType === "Condition" && resource.clinicalStatus?.coding?.some((c) => ["inactive", "resolved"].includes(c.code)),
   // Only include active care plans
@@ -504,6 +507,28 @@ var TemplateUtilities = class {
     return "";
   }
   extractObservationValue(observation) {
+    if (observation.code && observation.code.coding && "component" in observation && Array.isArray(observation.component)) {
+      const bpCode = observation.code.coding.find(
+        (c) => c.code === BLOOD_PRESSURE_LOINC_CODES.OBSERVATION
+      );
+      if (bpCode) {
+        const systolicComponent = observation.component?.find(
+          (c) => c.code?.coding?.some(
+            (cc) => cc.code === BLOOD_PRESSURE_LOINC_CODES.SYSTOLIC
+          )
+        );
+        const diastolicComponent = observation.component?.find(
+          (c) => c.code?.coding?.some(
+            (cc) => cc.code === BLOOD_PRESSURE_LOINC_CODES.DIASTOLIC
+          )
+        );
+        if (systolicComponent && diastolicComponent) {
+          const systolic = this.extractObservationValue(systolicComponent);
+          const diastolic = this.extractObservationValue(diastolicComponent);
+          return `${systolic}/${diastolic}`;
+        }
+      }
+    }
     const valueFields = [
       "valueString",
       "valueInteger",
@@ -826,7 +851,9 @@ var PatientTemplate = class _PatientTemplate {
     patient.name.forEach((name) => {
       if (name.use !== "old") {
         const nameText = name.text || ((name.given || []).join(" ") + " " + (name.family || "")).trim();
-        uniqueNames.add(nameText);
+        if (nameText) {
+          uniqueNames.add(nameText);
+        }
       }
     });
     return Array.from(uniqueNames).map((nameText) => `<ul><li>${nameText}</li></ul>`).join("");
@@ -856,9 +883,10 @@ var PatientTemplate = class _PatientTemplate {
       return "";
     }
     const systemPriority = ["email", "phone", "pager", "sms", "fax", "url", "other"];
+    const numberSystems = ["phone", "pager", "sms", "fax"];
     const telecomBySystem = /* @__PURE__ */ new Map();
     patient.telecom.forEach((telecom) => {
-      if (telecom.system && telecom.value) {
+      if (telecom.system && telecom.value && telecom.use !== "old") {
         const system = telecom.system.toLowerCase();
         if (!telecomBySystem.has(system)) {
           telecomBySystem.set(system, /* @__PURE__ */ new Set());
@@ -866,6 +894,29 @@ var PatientTemplate = class _PatientTemplate {
         telecomBySystem.get(system).add(telecom.value);
       }
     });
+    for (const system of numberSystems) {
+      const currentNumbers = Array.from(telecomBySystem.get(system) || []);
+      if (currentNumbers.length <= 1) continue;
+      const numbersWithCleaned = currentNumbers.map((num) => ({
+        original: num,
+        cleaned: num.replace(/\D/g, "")
+      }));
+      const toRemove = /* @__PURE__ */ new Set();
+      for (let i = 0; i < numbersWithCleaned.length; i++) {
+        for (let j = i + 1; j < numbersWithCleaned.length; j++) {
+          const num1 = numbersWithCleaned[i];
+          const num2 = numbersWithCleaned[j];
+          if (num1.cleaned.endsWith(num2.cleaned)) {
+            toRemove.add(num2.original);
+          } else if (num2.cleaned.endsWith(num1.cleaned)) {
+            toRemove.add(num1.original);
+          }
+        }
+      }
+      toRemove.forEach((numberToRemove) => {
+        telecomBySystem.get(system)?.delete(numberToRemove);
+      });
+    }
     return Array.from(telecomBySystem.entries()).sort(([systemA], [systemB]) => {
       const priorityA = systemPriority.indexOf(systemA);
       const priorityB = systemPriority.indexOf(systemB);
@@ -892,7 +943,24 @@ var PatientTemplate = class _PatientTemplate {
     }
     const uniqueAddresses = /* @__PURE__ */ new Set();
     patient.address.forEach((address) => {
-      const addressText = address.text || ((address.line || []).join(", ") + ", " + (address.city || "") + ", " + (address.country || "")).trim();
+      if (address.use === "old") {
+        return;
+      }
+      const addressArray = [];
+      if (address.text) {
+        addressArray.push(address.text);
+      } else {
+        if (address.line) {
+          addressArray.push(...address.line);
+        }
+        if (address.city) {
+          addressArray.push(address.city);
+        }
+        if (address.country) {
+          addressArray.push(address.country);
+        }
+      }
+      const addressText = addressArray.join(", ").trim();
       if (addressText) {
         uniqueAddresses.add(addressText);
       }
@@ -923,12 +991,18 @@ var PatientTemplate = class _PatientTemplate {
     if (!patient.communication || patient.communication.length === 0) {
       return "";
     }
-    return patient.communication.map((comm) => {
-      if (!comm.language) return "";
+    const uniqueLanguages = /* @__PURE__ */ new Set();
+    const preferredLanguages = /* @__PURE__ */ new Set();
+    patient.communication.forEach((comm) => {
       const language = templateUtilities.codeableConcept(comm.language);
-      const preferred = comm.preferred ? " (preferred)" : "";
-      return `<ul><li>${language}${preferred}</li></ul>`;
-    }).join("");
+      if (language) {
+        if (comm.preferred) {
+          preferredLanguages.add(language);
+        }
+        uniqueLanguages.add(language);
+      }
+    });
+    return Array.from(uniqueLanguages).map((language) => `<ul><li>${language}${preferredLanguages.has(language) ? " (preferred)" : ""}</li></ul>`).join("");
   }
   /**
    * Capitalizes first letter of a string
@@ -965,8 +1039,8 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
     if (resource.entry && Array.isArray(resource.entry)) {
       for (const entry of resource.entry) {
         const allergy = entry.resource;
-        const status = allergy.clinicalStatus?.coding?.[0]?.code || "";
-        if (status === "inactive" || status === "resolved") {
+        const isResolved = allergy.clinicalStatus?.coding?.some((c) => ["inactive", "resolved"].includes(c.code));
+        if (isResolved) {
           resolvedAllergies.push(allergy);
         } else {
           activeAllergies.push(allergy);
@@ -994,7 +1068,6 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
               <th>Status</th>
               <th>Category</th>
               <th>Reaction</th>
-              <th>Severity</th>
               <th>Onset Date</th>
               <th>Comments</th>
             </tr>
@@ -1022,7 +1095,6 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
               <th>Status</th>
               <th>Category</th>
               <th>Reaction</th>
-              <th>Severity</th>
               <th>Onset Date</th>
               <th>Comments</th>
               <th>Resolved Date</th>
@@ -1060,7 +1132,6 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
           <td class="Status">${templateUtilities.codeableConcept(allergy.clinicalStatus) || "-"}</td>
           <td class="Category">${templateUtilities.safeConcat(allergy.category) || "-"}</td>
           <td class="Reaction">${templateUtilities.concatReactionManifestation(allergy.reaction) || "-"}</td>
-          <td class="Severity">${templateUtilities.safeConcat(allergy.reaction, "severity") || "-"}</td>
           <td class="OnsetDate">${templateUtilities.renderTime(allergy.onsetDateTime, timezone) || "-"}</td>
           <td class="Comments">${templateUtilities.renderNotes(allergy.note, timezone, { styled: true, warning: true })}</td>`;
       if (includeResolved) {
@@ -1210,11 +1281,11 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
     };
     if (allActiveMedications.length > 0) {
       sortMedications(allActiveMedications);
-      html += this.renderCombinedMedications(templateUtilities, allActiveMedications, "Active Medications");
+      html += this.renderCombinedMedications(templateUtilities, allActiveMedications, true);
     }
     if (allInactiveMedications.length > 0) {
       sortMedications(allInactiveMedications);
-      html += this.renderCombinedMedications(templateUtilities, allInactiveMedications, "Inactive Medications");
+      html += this.renderCombinedMedications(templateUtilities, allInactiveMedications, false);
     }
     return html;
   }
@@ -1255,9 +1326,9 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
    * @param sectionTitle - Title for the section
    * @returns HTML string for rendering
    */
-  static renderCombinedMedications(templateUtilities, medications, sectionTitle) {
+  static renderCombinedMedications(templateUtilities, medications, isActiveSection) {
     let html = `
-    <h3>${sectionTitle}</h3>
+    <h3>${isActiveSection ? "Active Medications" : "Inactive Medications"}</h3>
       <table>
         <thead>
           <tr>
@@ -1266,8 +1337,8 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
             <th>Sig</th>
             <th>Dispense Quantity</th>
             <th>Refills</th>
-            <th>Start Date</th>
-            <th>End Date</th>
+            <th>Start Date</th>${isActiveSection ? "" : `
+            <th>End Date</th>`}
             <th>Status</th>
           </tr>
         </thead>
@@ -1325,8 +1396,8 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
           <td>${sig}</td>
           <td>${dispenseQuantity}</td>
           <td>${refills}</td>
-          <td>${startDate}</td>
-          <td>${endDate}</td>
+          <td>${startDate}</td>${isActiveSection ? "" : `
+          <td>${endDate}</td>`}
           <td>${status}</td>
         </tr>`;
     }
@@ -1432,7 +1503,6 @@ var ProblemListTemplate = class _ProblemListTemplate {
           <thead>
             <tr>
               <th>Problem</th>
-              <th>Severity</th>
               <th>Onset Date</th>
               <th>Recorded Date</th>
               <th>Notes</th>
@@ -1442,7 +1512,6 @@ var ProblemListTemplate = class _ProblemListTemplate {
     for (const cond of activeConditions) {
       html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
           <td class="Name">${templateUtilities.codeableConcept(cond.code)}</td>
-          <td class="Severity">${templateUtilities.codeableConcept(cond.severity)}</td>
           <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
           <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
           <td class="Notes">${templateUtilities.renderNotes(cond.note, timezone)}</td>
@@ -1686,7 +1755,6 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
         <thead>
           <tr>
             <th>Report</th>
-            <th>Status</th>
             <th>Category</th>
             <th>Result</th>
             <th>Issued</th>
@@ -1701,7 +1769,6 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
       html += `
         <tr id="${templateUtilities.narrativeLinkId(report)}">
           <td>${templateUtilities.codeableConcept(report.code)}</td>
-          <td>${report.status || ""}</td>
           <td>${templateUtilities.firstFromCodeableConceptList(report.category)}</td>
           <td>${resultCount}</td>
           <td>${report.issued ? templateUtilities.renderTime(report.issued, timezone) : ""}</td>
@@ -1842,7 +1909,6 @@ var PastHistoryOfIllnessTemplate = class {
           <thead>
             <tr>
               <th>Problem</th>
-              <th>Severity</th>
               <th>Onset Date</th>
               <th>Recorded Date</th>
               <th>Resolved Date</th>
@@ -1853,7 +1919,6 @@ var PastHistoryOfIllnessTemplate = class {
     for (const cond of resolvedConditions) {
       html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
           <td class="Name">${templateUtilities.codeableConcept(cond.code)}</td>
-          <td class="Severity">${templateUtilities.codeableConcept(cond.severity)}</td>
           <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
           <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
           <td class="ResolvedDate">${templateUtilities.renderDate(cond.abatementDateTime)}</td>
@@ -1964,7 +2029,6 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
           <thead>
             <tr>
               <th>Problem</th>
-              <th>Severity</th>
               <th>Onset Date</th>
               <th>Recorded Date</th>
               <th>Notes</th>
@@ -1974,7 +2038,6 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
       for (const cond of activeConditions) {
         html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
           <td class="Name">${templateUtilities.codeableConcept(cond.code)}</td>
-          <td class="Severity">${templateUtilities.codeableConcept(cond.severity)}</td>
           <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
           <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
           <td class="Notes">${templateUtilities.renderNotes(cond.note, timezone, { styled: true, warning: true })}</td>

package/package.json

@@ -1,6 +1,6 @@
 {
   "name": "@imranq2/fhirpatientsummary",
-  "version": "1.0.14",
+  "version": "1.0.16",
   "description": "A template for creating npm packages using TypeScript and VSCode",
   "main": "./dist/index.js",
   "module": "./dist/index.mjs",