@imranq2/fhirpatientsummary 1.0.15 → 1.0.17

package/dist/index.js

@@ -75,35 +75,28 @@ 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 = {
-  ["Patient" /* PATIENT */]: ["Patient"],
-  ["AllergyIntoleranceSection" /* ALLERGIES */]: ["AllergyIntolerance"],
-  ["MedicationSummarySection" /* MEDICATIONS */]: ["MedicationRequest", "MedicationStatement", "Medication"],
-  // Medication resource is needed for identifying name of medication
-  ["ProblemSection" /* PROBLEMS */]: ["Condition"],
-  ["ImmunizationSection" /* IMMUNIZATIONS */]: ["Immunization", "Organization"],
-  // Immunization can include Organization as a related resource
-  ["VitalSignsSection" /* VITAL_SIGNS */]: ["Observation"],
-  ["MedicalDeviceSection" /* MEDICAL_DEVICES */]: ["DeviceUseStatement", "Device"],
-  // Device resource is used for medical devices name
-  ["ResultsSection" /* DIAGNOSTIC_REPORTS */]: ["DiagnosticReport", "Observation"],
-  ["HistoryOfProceduresSection" /* PROCEDURES */]: ["Procedure"],
-  ["SocialHistorySection" /* SOCIAL_HISTORY */]: ["Observation"],
-  ["HistoryOfPregnancySection" /* PREGNANCY_HISTORY */]: ["Observation"],
-  ["FunctionalStatusSection" /* FUNCTIONAL_STATUS */]: ["Condition", "ClinicalImpression"],
-  ["HistoryOfPastIllnessSection" /* MEDICAL_HISTORY */]: ["Condition"],
-  ["PlanOfCareSection" /* CARE_PLAN */]: ["CarePlan"],
-  ["AdvanceDirectivesSection" /* ADVANCE_DIRECTIVES */]: ["Consent"]
-};
 var IPSSectionResourceFilters = {
+  // Patient section: only Patient resource
+  ["Patient" /* PATIENT */]: (resource) => resource.resourceType === "Patient",
+  // Only include allergies
+  ["AllergyIntoleranceSection" /* ALLERGIES */]: (resource) => resource.resourceType === "AllergyIntolerance",
+  // includes MedicationRequest, MedicationStatement. Medication is needed for medication names
+  ["MedicationSummarySection" /* MEDICATIONS */]: (resource) => ["MedicationRequest", "MedicationStatement", "Medication"].includes(resource.resourceType),
   // 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",
   // Only include vital sign Observations (category.coding contains 'vital-signs')
   ["VitalSignsSection" /* VITAL_SIGNS */]: (resource) => resource.resourceType === "Observation" && resource.category?.some((cat) => cat.coding?.some((c) => c.code === "vital-signs")),
+  // Includes DeviceUseStatement. Device is needed for linked device details
+  ["MedicalDeviceSection" /* MEDICAL_DEVICES */]: (resource) => ["DeviceUseStatement", "Device"].includes(resource.resourceType),
   // Only include finalized diagnostic reports
   ["ResultsSection" /* DIAGNOSTIC_REPORTS */]: (resource) => ["DiagnosticReport", "Observation"].includes(resource.resourceType) && resource.status === "final",
   // Only include completed procedures
@@ -119,14 +112,9 @@ var IPSSectionResourceFilters = {
   // Only include active care plans
   ["PlanOfCareSection" /* CARE_PLAN */]: (resource) => resource.resourceType === "CarePlan" && resource.status === "active",
   // Only include active advance directives (Consent resources)
-  ["AdvanceDirectivesSection" /* ADVANCE_DIRECTIVES */]: (resource) => resource.resourceType === "Consent" && resource.status === "active",
-  // Patient section: only Patient resource
-  ["Patient" /* PATIENT */]: (resource) => resource.resourceType === "Patient"
+  ["AdvanceDirectivesSection" /* ADVANCE_DIRECTIVES */]: (resource) => resource.resourceType === "Consent" && resource.status === "active"
 };
 var IPSSectionResourceHelper = class {
-  static getResourceTypesForSection(section) {
-    return IPSSectionResourceMap[section] || [];
-  }
   static getResourceFilterForSection(section) {
     return IPSSectionResourceFilters[section];
   }
@@ -136,11 +124,11 @@ var IPSSectionResourceHelper = class {
 import { DateTime } from "luxon";
 var TemplateUtilities = class {
   /**
-   * Constructor to initialize the TemplateUtilities with a FHIR Bundle
-   * @param bundle - FHIR Bundle containing resources
+   * Constructor to initialize the TemplateUtilities with a FHIR resources
+   * @param resources - FHIR resources
    */
-  constructor(bundle) {
-    this.bundle = bundle;
+  constructor(resources) {
+    this.resources = resources;
   }
   /**
    * Formats a CodeableConcept object
@@ -171,7 +159,7 @@ var TemplateUtilities = class {
     return "";
   }
   resolveReference(ref) {
-    if (!ref || !this.bundle || !this.bundle.entry) {
+    if (!ref || !this.resources) {
       return null;
     }
     const referenceParts = ref.reference?.split("/");
@@ -180,10 +168,10 @@ var TemplateUtilities = class {
     }
     const referenceResourceType = referenceParts[0];
     const referenceResourceId = referenceParts[1];
-    const resource = this.bundle.entry.find((entry) => {
-      return entry.resource && entry.resource.resourceType === referenceResourceType && entry.resource.id === referenceResourceId;
+    const resource = this.resources.find((entry) => {
+      return entry.resourceType === referenceResourceType && entry.id === referenceResourceId;
     });
-    return resource ? resource.resource : null;
+    return resource ? resource : null;
   }
   /**
    * Renders a Device reference
@@ -502,6 +490,28 @@ 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",
@@ -732,7 +742,7 @@ var TemplateUtilities = class {
       if (parts.length === 2) {
         const resourceType = parts[0];
         const resourceId = parts[1];
-        const resource = this.bundle.entry?.find((entry) => entry.resource?.resourceType === resourceType && entry.resource?.id === resourceId);
+        const resource = this.resources?.find((resource2) => resource2.resourceType === resourceType && resource2.id === resourceId);
         if (resource) {
           return `${resourceType}/${resourceId}`;
         }
@@ -772,48 +782,96 @@ var TemplateUtilities = class {
 // src/narratives/templates/typescript/PatientTemplate.ts
 var PatientTemplate = class _PatientTemplate {
   /**
-   * Generate HTML narrative for Patient resource
-   * @param resource - FHIR Bundle containing Patient resource
+   * Generate HTML narrative for Patient resources
+   * @param resources - FHIR Patient resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  generateNarrative(resource, timezone) {
-    return _PatientTemplate.generateStaticNarrative(resource, timezone);
+  generateNarrative(resources, timezone) {
+    return _PatientTemplate.generateStaticNarrative(resources, timezone);
   }
   /**
    * Internal static implementation that actually generates the narrative
-   * @param resource - FHIR Bundle containing Patient resource
+   * @param resources - FHIR Patient resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
   // eslint-disable-next-line @typescript-eslint/no-unused-vars
-  static generateStaticNarrative(resource, timezone) {
-    const templateUtilities = new TemplateUtilities(resource);
-    let html = "";
-    for (const entry of resource.entry || []) {
-      if (entry.resource?.resourceType === "Patient") {
-        const patient = entry.resource;
-        html += `
-        <div>
-          <ul>
-            <li><strong>Name(s):</strong>${this.renderNames(patient)}</li>
-            <li><strong>Gender:</strong>${patient.gender ? this.capitalize(patient.gender) : ""}</li>
-            <li><strong>Date of Birth:</strong>${patient.birthDate || ""}</li>
-            <li><strong>Identifier(s):</strong>${this.renderIdentifiers(patient)}</li>
-            <li><strong>Telecom:</strong><ul>${this.renderTelecom(patient)}</ul></li>
-            <li><strong>Address(es):</strong>${this.renderAddresses(patient)}</li>
-            <li><strong>Marital Status:</strong> ${patient.maritalStatus?.text || ""}</li>
-            <li><strong>Deceased:</strong>${this.renderDeceased(patient)}</li>
-            <li><strong>Language(s):</strong>${this.renderCommunication(templateUtilities, patient)}</li>
-          </ul>
-        </div>`;
+  static generateStaticNarrative(resources, timezone) {
+    const templateUtilities = new TemplateUtilities(resources);
+    const combinedPatient = this.combinePatients(resources);
+    return `<div>
+      <ul>
+        <li><strong>Name(s):</strong>${this.renderNames(combinedPatient)}</li>
+        <li><strong>Gender:</strong>${combinedPatient.gender ? this.capitalize(combinedPatient.gender) : ""}</li>
+        <li><strong>Date of Birth:</strong>${combinedPatient.birthDate || ""}</li>
+        <li><strong>Identifier(s):</strong>${this.renderIdentifiers(combinedPatient)}</li>
+        <li><strong>Telecom:</strong><ul>${this.renderTelecom(combinedPatient)}</ul></li>
+        <li><strong>Address(es):</strong>${this.renderAddresses(combinedPatient)}</li>
+        <li><strong>Marital Status:</strong> ${combinedPatient.maritalStatus?.text || ""}</li>
+        <li><strong>Deceased:</strong>${this.renderDeceased(combinedPatient)}</li>
+        <li><strong>Language(s):</strong>${this.renderCommunication(templateUtilities, combinedPatient)}</li>
+      </ul>
+    </div>`;
+  }
+  /**
+   * Combines multiple patient resources into a single patient object
+   * Merges fields, preferring non-empty values
+   * @param patients - Array of patient resources
+   * @returns Combined patient resource
+   */
+  static combinePatients(patients) {
+    if (patients.length === 1) {
+      return patients[0];
+    }
+    const combined = patients[0];
+    const allNames = [];
+    const allIdentifiers = [];
+    const allTelecom = [];
+    const allAddresses = [];
+    const allCommunication = [];
+    patients.forEach((patient) => {
+      if (patient.name) {
+        allNames.push(...patient.name);
       }
-    }
-    return html;
+      if (patient.identifier) {
+        allIdentifiers.push(...patient.identifier);
+      }
+      if (patient.telecom) {
+        allTelecom.push(...patient.telecom);
+      }
+      if (patient.address) {
+        allAddresses.push(...patient.address);
+      }
+      if (patient.communication) {
+        allCommunication.push(...patient.communication);
+      }
+      if (!combined.gender && patient.gender) {
+        combined.gender = patient.gender;
+      }
+      if (!combined.birthDate && patient.birthDate) {
+        combined.birthDate = patient.birthDate;
+      }
+      if (!combined.maritalStatus && patient.maritalStatus) {
+        combined.maritalStatus = patient.maritalStatus;
+      }
+      if (!combined.deceasedBoolean && patient.deceasedBoolean !== void 0) {
+        combined.deceasedBoolean = patient.deceasedBoolean;
+      }
+      if (!combined.deceasedDateTime && patient.deceasedDateTime) {
+        combined.deceasedDateTime = patient.deceasedDateTime;
+      }
+    });
+    combined.name = allNames;
+    combined.identifier = allIdentifiers;
+    combined.telecom = allTelecom;
+    combined.address = allAddresses;
+    combined.communication = allCommunication;
+    return combined;
   }
   /**
    * Renders patient names as HTML list items
-   * @param patient - Patient resource
+   * @param patient - Patient resources
    * @returns HTML string of list items
    */
   static renderNames(patient) {
@@ -824,14 +882,16 @@ 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("");
   }
   /**
    * Renders patient identifiers as HTML list items
-   * @param patient - Patient resource
+   * @param patient - Patient resources
    * @returns HTML string of list items
    */
   static renderIdentifiers(patient) {
@@ -846,7 +906,7 @@ var PatientTemplate = class _PatientTemplate {
   }
   /**
    * Renders patient telecom information grouped by system
-   * @param patient - Patient resource
+   * @param patient - Patient resources
    * @returns HTML string grouped by system
    */
   static renderTelecom(patient) {
@@ -854,9 +914,10 @@ 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());
@@ -864,6 +925,29 @@ 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);
@@ -881,7 +965,7 @@ var PatientTemplate = class _PatientTemplate {
   }
   /**
    * Renders patient addresses as HTML list items
-   * @param patient - Patient resource
+   * @param patient - Patient resources
    * @returns HTML string of list items
    */
   static renderAddresses(patient) {
@@ -890,7 +974,33 @@ 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.district) {
+          addressArray.push(address.district);
+        }
+        if (address.state) {
+          addressArray.push(address.state);
+        }
+        if (address.country) {
+          addressArray.push(address.country);
+        }
+        if (address.postalCode) {
+          addressArray.push(address.postalCode);
+        }
+      }
+      const addressText = addressArray.join(", ").trim();
       if (addressText) {
         uniqueAddresses.add(addressText);
       }
@@ -899,7 +1009,7 @@ var PatientTemplate = class _PatientTemplate {
   }
   /**
    * Renders patient deceased status
-   * @param patient - Patient resource
+   * @param patient - Patient resources
    * @returns HTML string for deceased status
    */
   static renderDeceased(patient) {
@@ -914,19 +1024,25 @@ var PatientTemplate = class _PatientTemplate {
   /**
    * Renders patient communication preferences as HTML list items
    * @param templateUtilities - Instance of TemplateUtilities for utility functions
-   * @param patient - Patient resource
+   * @param patient - Patient resources
    * @returns HTML string of list items
    */
   static renderCommunication(templateUtilities, patient) {
     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
@@ -943,32 +1059,30 @@ var PatientTemplate = class _PatientTemplate {
 var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
   /**
    * Generate HTML narrative for AllergyIntolerance resources
-   * @param resource - FHIR Bundle containing AllergyIntolerance resources
+   * @param resources - FHIR resources array containing AllergyIntolerance resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  generateNarrative(resource, timezone) {
-    return _AllergyIntoleranceTemplate.generateStaticNarrative(resource, timezone);
+  generateNarrative(resources, timezone) {
+    return _AllergyIntoleranceTemplate.generateStaticNarrative(resources, timezone);
   }
   /**
    * Internal static implementation that actually generates the narrative
-   * @param resource - FHIR Bundle containing AllergyIntolerance resources
+   * @param resources - FHIR resources array containing AllergyIntolerance resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  static generateStaticNarrative(resource, timezone) {
-    const templateUtilities = new TemplateUtilities(resource);
+  static generateStaticNarrative(resources, timezone) {
+    const templateUtilities = new TemplateUtilities(resources);
     const activeAllergies = [];
     const resolvedAllergies = [];
-    if (resource.entry && Array.isArray(resource.entry)) {
-      for (const entry of resource.entry) {
-        const allergy = entry.resource;
-        const isResolved = allergy.clinicalStatus?.coding?.some((c) => ["inactive", "resolved"].includes(c.code));
-        if (isResolved) {
-          resolvedAllergies.push(allergy);
-        } else {
-          activeAllergies.push(allergy);
-        }
+    for (const resourceItem of resources) {
+      const allergy = resourceItem;
+      const isResolved = allergy.clinicalStatus?.coding?.some((c) => ["inactive", "resolved"].includes(c.code));
+      if (isResolved) {
+        resolvedAllergies.push(allergy);
+      } else {
+        activeAllergies.push(allergy);
       }
     }
     activeAllergies.sort((a, b) => {
@@ -992,7 +1106,6 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
               <th>Status</th>
               <th>Category</th>
               <th>Reaction</th>
-              <th>Severity</th>
               <th>Onset Date</th>
               <th>Comments</th>
             </tr>
@@ -1020,7 +1133,6 @@ 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>
@@ -1058,7 +1170,6 @@ 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) {
@@ -1084,12 +1195,12 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
 var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
   /**
    * Generate HTML narrative for Medication resources
-   * @param resource - FHIR Bundle containing Medication resources
+   * @param resources - FHIR Medication resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  generateNarrative(resource, timezone) {
-    return _MedicationSummaryTemplate.generateStaticNarrative(resource, timezone);
+  generateNarrative(resources, timezone) {
+    return _MedicationSummaryTemplate.generateStaticNarrative(resources, timezone);
   }
   /**
    * Safely parse a date string and return a valid Date object or null
@@ -1154,16 +1265,16 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
   }
   /**
    * Internal static implementation that actually generates the narrative
-   * @param resource - FHIR Bundle containing Medication resources
+   * @param resources - FHIR Medication resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
   // eslint-disable-next-line @typescript-eslint/no-unused-vars
-  static generateStaticNarrative(resource, timezone) {
-    const templateUtilities = new TemplateUtilities(resource);
+  static generateStaticNarrative(resources, timezone) {
+    const templateUtilities = new TemplateUtilities(resources);
     let html = "";
-    const medicationRequests = this.getMedicationRequests(templateUtilities, resource);
-    const medicationStatements = this.getMedicationStatements(templateUtilities, resource);
+    const medicationRequests = this.getMedicationRequests(templateUtilities, resources);
+    const medicationStatements = this.getMedicationStatements(templateUtilities, resources);
     const allActiveMedications = [];
     const allInactiveMedications = [];
     medicationRequests.forEach((mr) => {
@@ -1208,42 +1319,42 @@ 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;
   }
   /**
-   * Extract MedicationRequest resources from the bundle
+   * Extract MedicationRequest resources
    * @param templateUtilities - Instance of TemplateUtilities for utility functions
-   * @param resource - FHIR Bundle
+   * @param resources - FHIR Medication resources
    * @returns Array of MedicationRequest resources
    */
-  static getMedicationRequests(templateUtilities, resource) {
-    if (!resource.entry || !Array.isArray(resource.entry)) {
+  static getMedicationRequests(templateUtilities, resources) {
+    if (resources.length === 0) {
       return [];
     }
-    return resource.entry.filter((entry) => entry.resource?.resourceType === "MedicationRequest").map((entry) => ({
-      resource: entry.resource,
-      extension: templateUtilities.narrativeLinkExtension(entry.resource)
+    return resources.filter((entry) => entry.resourceType === "MedicationRequest").map((entry) => ({
+      resource: entry,
+      extension: templateUtilities.narrativeLinkExtension(entry)
     }));
   }
   /**
-   * Extract MedicationStatement resources from the bundle
+   * Extract MedicationStatement resources
    * @param templateUtilities - Instance of TemplateUtilities for utility functions
-   * @param resource - FHIR Bundle
+   * @param resources - FHIR Medication resources
    * @returns Array of MedicationStatement resources
    */
-  static getMedicationStatements(templateUtilities, resource) {
-    if (!resource.entry || !Array.isArray(resource.entry)) {
+  static getMedicationStatements(templateUtilities, resources) {
+    if (resources.length === 0) {
       return [];
     }
-    return resource.entry.filter((entry) => entry.resource?.resourceType === "MedicationStatement").map((entry) => ({
-      resource: entry.resource,
-      extension: templateUtilities.narrativeLinkExtension(entry.resource)
+    return resources.filter((entry) => entry.resourceType === "MedicationStatement").map((entry) => ({
+      resource: entry,
+      extension: templateUtilities.narrativeLinkExtension(entry)
     }));
   }
   /**
@@ -1253,9 +1364,9 @@ 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>
@@ -1264,8 +1375,8 @@ 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>${isActiveSection ? "" : `
+            <th>End Date</th>`}
             <th>Status</th>
           </tr>
         </thead>
@@ -1323,8 +1434,8 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
           <td>${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>`;
     }
@@ -1339,28 +1450,26 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
 var ImmunizationsTemplate = class _ImmunizationsTemplate {
   /**
    * Generate HTML narrative for Immunization resources
-   * @param resource - FHIR Bundle containing Immunization resources
+   * @param resources - FHIR resources array containing Immunization resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  generateNarrative(resource, timezone) {
-    if (resource.entry && Array.isArray(resource.entry)) {
-      resource.entry.sort((a, b) => {
-        const dateA = a.resource?.occurrenceDateTime;
-        const dateB = b.resource?.occurrenceDateTime;
-        return typeof dateA === "string" && typeof dateB === "string" ? new Date(dateB).getTime() - new Date(dateA).getTime() : 0;
-      });
-    }
-    return _ImmunizationsTemplate.generateStaticNarrative(resource, timezone);
+  generateNarrative(resources, timezone) {
+    resources.sort((a, b) => {
+      const dateA = a.occurrenceDateTime;
+      const dateB = b.occurrenceDateTime;
+      return typeof dateA === "string" && typeof dateB === "string" ? new Date(dateB).getTime() - new Date(dateA).getTime() : 0;
+    });
+    return _ImmunizationsTemplate.generateStaticNarrative(resources, timezone);
   }
   /**
    * Internal static implementation that actually generates the narrative
-   * @param resource - FHIR Bundle containing Immunization resources
+   * @param resources - FHIR resources array containing Immunization resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  static generateStaticNarrative(resource, timezone) {
-    const templateUtilities = new TemplateUtilities(resource);
+  static generateStaticNarrative(resources, timezone) {
+    const templateUtilities = new TemplateUtilities(resources);
     let html = `
       <table>
         <thead>
@@ -1375,21 +1484,20 @@ var ImmunizationsTemplate = class _ImmunizationsTemplate {
           </tr>
         </thead>
         <tbody>`;
-    if (resource.entry && Array.isArray(resource.entry)) {
-      for (const entry of resource.entry) {
-        if (entry.resource?.resourceType === "Immunization") {
-          const imm = entry.resource;
-          html += `
-            <tr id="${templateUtilities.narrativeLinkId(imm)}">
-              <td>${templateUtilities.codeableConcept(imm.vaccineCode)}</td>
-              <td>${imm.status || ""}</td>
-              <td>${templateUtilities.concatDoseNumber(imm.protocolApplied)}</td>
-              <td>${templateUtilities.renderVaccineManufacturer(imm)}</td>
-              <td>${imm.lotNumber || ""}</td>
-              <td>${templateUtilities.renderNotes(imm.note, timezone)}</td>
-              <td>${templateUtilities.renderTime(imm.occurrenceDateTime, timezone)}</td>
-            </tr>`;
-        }
+    const immunizations = resources.filter((resourceItem) => resourceItem.resourceType === "Immunization");
+    if (immunizations.length > 0) {
+      for (const resourceItem of immunizations) {
+        const imm = resourceItem;
+        html += `
+          <tr id="${templateUtilities.narrativeLinkId(imm)}">
+            <td>${templateUtilities.codeableConcept(imm.vaccineCode)}</td>
+            <td>${imm.status || ""}</td>
+            <td>${templateUtilities.concatDoseNumber(imm.protocolApplied)}</td>
+            <td>${templateUtilities.renderVaccineManufacturer(imm)}</td>
+            <td>${imm.lotNumber || ""}</td>
+            <td>${templateUtilities.renderNotes(imm.note, timezone)}</td>
+            <td>${templateUtilities.renderTime(imm.occurrenceDateTime, timezone)}</td>
+          </tr>`;
       }
     }
     html += `
@@ -1403,23 +1511,23 @@ var ImmunizationsTemplate = class _ImmunizationsTemplate {
 var ProblemListTemplate = class _ProblemListTemplate {
   /**
    * Generate HTML narrative for Problem List
-   * @param resource - FHIR Bundle containing Condition resources
+   * @param resources - FHIR Condition resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  generateNarrative(resource, timezone) {
-    return _ProblemListTemplate.generateStaticNarrative(resource, timezone);
+  generateNarrative(resources, timezone) {
+    return _ProblemListTemplate.generateStaticNarrative(resources, timezone);
   }
   /**
    * Internal static implementation that actually generates the narrative
-   * @param resource - FHIR Bundle containing Condition resources
+   * @param resources - FHIR Condition resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  static generateStaticNarrative(resource, timezone) {
-    const templateUtilities = new TemplateUtilities(resource);
+  static generateStaticNarrative(resources, timezone) {
+    const templateUtilities = new TemplateUtilities(resources);
     let html = ``;
-    const activeConditions = resource.entry?.map((entry) => entry.resource) || [];
+    const activeConditions = resources.map((entry) => entry) || [];
     activeConditions.sort((a, b) => {
       const dateA = a.onsetDateTime ? new Date(a.onsetDateTime).getTime() : 0;
       const dateB = b.onsetDateTime ? new Date(b.onsetDateTime).getTime() : 0;
@@ -1430,7 +1538,6 @@ var ProblemListTemplate = class _ProblemListTemplate {
           <thead>
             <tr>
               <th>Problem</th>
-              <th>Severity</th>
               <th>Onset Date</th>
               <th>Recorded Date</th>
               <th>Notes</th>
@@ -1440,7 +1547,6 @@ 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>
@@ -1456,22 +1562,22 @@ var ProblemListTemplate = class _ProblemListTemplate {
 var VitalSignsTemplate = class _VitalSignsTemplate {
   /**
    * Generate HTML narrative for Vital Signs
-   * @param resource - FHIR Bundle containing Observation resources
+   * @param resources - FHIR Observation resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  generateNarrative(resource, timezone) {
-    return _VitalSignsTemplate.generateStaticNarrative(resource, timezone);
+  generateNarrative(resources, timezone) {
+    return _VitalSignsTemplate.generateStaticNarrative(resources, timezone);
   }
   /**
    * Internal static implementation that actually generates the narrative
-   * @param resource - FHIR Bundle containing Observation resources
+   * @param resources - FHIR Observation resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  static generateStaticNarrative(resource, timezone) {
-    const templateUtilities = new TemplateUtilities(resource);
-    const observations = resource.entry?.map((entry) => entry.resource) || [];
+  static generateStaticNarrative(resources, timezone) {
+    const templateUtilities = new TemplateUtilities(resources);
+    const observations = resources.map((entry) => entry) || [];
     observations.sort((a, b) => {
       const dateA = a.effectiveDateTime || a.effectivePeriod?.start;
       const dateB = b.effectiveDateTime || b.effectivePeriod?.start;
@@ -1514,28 +1620,21 @@ var VitalSignsTemplate = class _VitalSignsTemplate {
 var MedicalDevicesTemplate = class _MedicalDevicesTemplate {
   /**
    * Generate HTML narrative for Medical Device resources
-   * @param resource - FHIR Bundle containing Device resources
+   * @param resources - FHIR resources array containing Device resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  generateNarrative(resource, timezone) {
-    if (resource.entry && Array.isArray(resource.entry)) {
-      resource.entry.sort((a, b) => {
-        const dateA = a.resource?.recordedOn;
-        const dateB = b.resource?.recordedOn;
-        return typeof dateA === "string" && typeof dateB === "string" ? new Date(dateB).getTime() - new Date(dateA).getTime() : 0;
-      });
-    }
-    return _MedicalDevicesTemplate.generateStaticNarrative(resource, timezone);
+  generateNarrative(resources, timezone) {
+    return _MedicalDevicesTemplate.generateStaticNarrative(resources, timezone);
   }
   /**
    * Internal static implementation that actually generates the narrative
-   * @param resource - FHIR Bundle containing Device resources
+   * @param resources - FHIR resources array containing Device resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  static generateStaticNarrative(resource, timezone) {
-    const templateUtilities = new TemplateUtilities(resource);
+  static generateStaticNarrative(resources, timezone) {
+    const templateUtilities = new TemplateUtilities(resources);
     let html = `
       <table>
         <thead>
@@ -1547,19 +1646,19 @@ var MedicalDevicesTemplate = class _MedicalDevicesTemplate {
           </tr>
         </thead>
         <tbody>`;
-    if (resource.entry && Array.isArray(resource.entry)) {
-      for (const entry of resource.entry) {
-        if (entry.resource?.resourceType === "DeviceUseStatement") {
-          const dus = entry.resource;
-          html += `
-            <tr id="${templateUtilities.narrativeLinkId(dus)}">
-              <td>${templateUtilities.renderDevice(dus.device)}</td>
-              <td>${dus.status || ""}</td>
-              <td>${templateUtilities.renderNotes(dus.note, timezone)}</td>
-              <td>${templateUtilities.renderRecorded(dus.recordedOn, timezone)}</td>
-            </tr>`;
-        }
-      }
+    const deviceStatements = resources.filter((resourceItem) => resourceItem.resourceType === "DeviceUseStatement").map((resourceItem) => resourceItem).sort((a, b) => {
+      const dateA = a.recordedOn;
+      const dateB = b.recordedOn;
+      return typeof dateA === "string" && typeof dateB === "string" ? new Date(dateB).getTime() - new Date(dateA).getTime() : 0;
+    });
+    for (const dus of deviceStatements) {
+      html += `
+        <tr id="${templateUtilities.narrativeLinkId(dus)}">
+          <td>${templateUtilities.renderDevice(dus.device)}</td>
+          <td>${dus.status || ""}</td>
+          <td>${templateUtilities.renderNotes(dus.note, timezone)}</td>
+          <td>${templateUtilities.renderRecorded(dus.recordedOn, timezone)}</td>
+        </tr>`;
     }
     html += `
         </tbody>
@@ -1572,23 +1671,23 @@ var MedicalDevicesTemplate = class _MedicalDevicesTemplate {
 var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
   /**
    * Generate HTML narrative for Diagnostic Results
-   * @param resource - FHIR Bundle containing Observation and DiagnosticReport resources
+   * @param resources - FHIR resources array containing Observation and DiagnosticReport resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  generateNarrative(resource, timezone) {
-    return _DiagnosticResultsTemplate.generateStaticNarrative(resource, timezone);
+  generateNarrative(resources, timezone) {
+    return _DiagnosticResultsTemplate.generateStaticNarrative(resources, timezone);
   }
   /**
    * Internal static implementation that actually generates the narrative
-   * @param resource - FHIR Bundle containing Observation and DiagnosticReport resources
+   * @param resources - FHIR resources array containing Observation and DiagnosticReport resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  static generateStaticNarrative(resource, timezone) {
-    const templateUtilities = new TemplateUtilities(resource);
+  static generateStaticNarrative(resources, timezone) {
+    const templateUtilities = new TemplateUtilities(resources);
     let html = "";
-    const observations = this.getObservations(resource);
+    const observations = this.getObservations(resources);
     if (observations.length > 0) {
       observations.sort((a, b) => {
         const dateA = a.effectiveDateTime || a.effectivePeriod?.start;
@@ -1597,7 +1696,7 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
       });
       html += this.renderObservations(templateUtilities, observations, timezone);
     }
-    const diagnosticReports = this.getDiagnosticReports(resource);
+    const diagnosticReports = this.getDiagnosticReports(resources);
     if (diagnosticReports.length > 0) {
       diagnosticReports.sort((a, b) => {
         const dateA = a.issued;
@@ -1609,26 +1708,20 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
     return html;
   }
   /**
-   * Extract Observation resources from the bundle
-   * @param resource - FHIR Bundle
-   * @returns Array of Observation resources
-   */
-  static getObservations(resource) {
-    if (!resource.entry || !Array.isArray(resource.entry)) {
-      return [];
-    }
-    return resource.entry.filter((entry) => entry.resource?.resourceType === "Observation").map((entry) => entry.resource);
+  * Get all Observation resources from the resource array
+  * @param resources - FHIR resources array
+  * @returns Array of Observation resources
+  */
+  static getObservations(resources) {
+    return resources.filter((resourceItem) => resourceItem.resourceType === "Observation").map((resourceItem) => resourceItem);
   }
   /**
-   * Extract DiagnosticReport resources from the bundle
-   * @param resource - FHIR Bundle
+   * Get all DiagnosticReport resources from the resource array
+   * @param resources - FHIR resources array
    * @returns Array of DiagnosticReport resources
    */
-  static getDiagnosticReports(resource) {
-    if (!resource.entry || !Array.isArray(resource.entry)) {
-      return [];
-    }
-    return resource.entry.filter((entry) => entry.resource?.resourceType === "DiagnosticReport").map((entry) => entry.resource);
+  static getDiagnosticReports(resources) {
+    return resources.filter((resourceItem) => resourceItem.resourceType === "DiagnosticReport").map((resourceItem) => resourceItem);
   }
   /**
    * Render HTML table for Observation resources
@@ -1684,7 +1777,6 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
         <thead>
           <tr>
             <th>Report</th>
-            <th>Status</th>
             <th>Category</th>
             <th>Result</th>
             <th>Issued</th>
@@ -1699,7 +1791,6 @@ 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>
@@ -1716,26 +1807,26 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
 var HistoryOfProceduresTemplate = class _HistoryOfProceduresTemplate {
   /**
    * Generate HTML narrative for Procedure resources
-   * @param resource - FHIR Bundle containing Procedure resources
+   * @param resources - FHIR Procedure resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  generateNarrative(resource, timezone) {
-    resource.entry?.sort((a, b) => {
-      const dateA = a.resource.performedDateTime || a.resource.performedPeriod?.start;
-      const dateB = b.resource.performedDateTime || b.resource.performedPeriod?.start;
+  generateNarrative(resources, timezone) {
+    resources.sort((a, b) => {
+      const dateA = a.performedDateTime || a.performedPeriod?.start;
+      const dateB = b.performedDateTime || b.performedPeriod?.start;
       return dateA && dateB ? new Date(dateB).getTime() - new Date(dateA).getTime() : 0;
     });
-    return _HistoryOfProceduresTemplate.generateStaticNarrative(resource, timezone);
+    return _HistoryOfProceduresTemplate.generateStaticNarrative(resources, timezone);
   }
   /**
    * Internal static implementation that actually generates the narrative
-   * @param resource - FHIR Bundle containing Procedure resources
+   * @param resources - FHIR Procedure resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  static generateStaticNarrative(resource, timezone) {
-    const templateUtilities = new TemplateUtilities(resource);
+  static generateStaticNarrative(resources, timezone) {
+    const templateUtilities = new TemplateUtilities(resources);
     let html = `
       <table>
         <thead>
@@ -1746,16 +1837,14 @@ var HistoryOfProceduresTemplate = class _HistoryOfProceduresTemplate {
           </tr>
         </thead>
         <tbody>`;
-    if (resource.entry && Array.isArray(resource.entry)) {
-      for (const entry of resource.entry) {
-        const proc = entry.resource;
-        html += `
-          <tr id="${templateUtilities.narrativeLinkId(proc)}">
-            <td>${templateUtilities.codeableConcept(proc.code, "display")}</td>
-            <td>${templateUtilities.renderNotes(proc.note, timezone)}</td>
-            <td>${proc.performedDateTime ? templateUtilities.renderTime(proc.performedDateTime, timezone) : proc.performedPeriod ? templateUtilities.renderPeriod(proc.performedPeriod, timezone) : ""}</td>
-          </tr>`;
-      }
+    for (const resourceItem of resources) {
+      const proc = resourceItem;
+      html += `
+        <tr id="${templateUtilities.narrativeLinkId(proc)}">
+          <td>${templateUtilities.codeableConcept(proc.code, "display")}</td>
+          <td>${templateUtilities.renderNotes(proc.note, timezone)}</td>
+          <td>${proc.performedDateTime ? templateUtilities.renderTime(proc.performedDateTime, timezone) : proc.performedPeriod ? templateUtilities.renderPeriod(proc.performedPeriod, timezone) : ""}</td>
+        </tr>`;
     }
     html += `
         </tbody>
@@ -1768,22 +1857,22 @@ var HistoryOfProceduresTemplate = class _HistoryOfProceduresTemplate {
 var SocialHistoryTemplate = class _SocialHistoryTemplate {
   /**
    * Generate HTML narrative for Social History
-   * @param resource - FHIR Bundle containing Observation resources
+   * @param resources - FHIR Observation resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  generateNarrative(resource, timezone) {
-    return _SocialHistoryTemplate.generateStaticNarrative(resource, timezone);
+  generateNarrative(resources, timezone) {
+    return _SocialHistoryTemplate.generateStaticNarrative(resources, timezone);
   }
   /**
    * Internal static implementation that actually generates the narrative
-   * @param resource - FHIR Bundle containing Observation resources
+   * @param resources - FHIR Observation resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  static generateStaticNarrative(resource, timezone) {
-    const templateUtilities = new TemplateUtilities(resource);
-    const observations = resource.entry?.map((entry) => entry.resource) || [];
+  static generateStaticNarrative(resources, timezone) {
+    const templateUtilities = new TemplateUtilities(resources);
+    const observations = resources.map((entry) => entry) || [];
     observations.sort((a, b) => {
       const dateA = a.effectiveDateTime || a.effectivePeriod?.start;
       const dateB = b.effectiveDateTime || b.effectivePeriod?.start;
@@ -1822,14 +1911,14 @@ var SocialHistoryTemplate = class _SocialHistoryTemplate {
 var PastHistoryOfIllnessTemplate = class {
   /**
    * Generate HTML narrative for Past History of Illnesses
-   * @param resource - FHIR Bundle containing Condition resources
+   * @param resources - FHIR Condition resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  generateNarrative(resource, timezone) {
-    const templateUtilities = new TemplateUtilities(resource);
+  generateNarrative(resources, timezone) {
+    const templateUtilities = new TemplateUtilities(resources);
     let html = ``;
-    const resolvedConditions = resource.entry?.map((entry) => entry.resource) || [];
+    const resolvedConditions = resources.map((entry) => entry) || [];
     resolvedConditions.sort((a, b) => {
       const dateA = a.onsetDateTime ? new Date(a.onsetDateTime).getTime() : 0;
       const dateB = b.onsetDateTime ? new Date(b.onsetDateTime).getTime() : 0;
@@ -1840,7 +1929,6 @@ var PastHistoryOfIllnessTemplate = class {
           <thead>
             <tr>
               <th>Problem</th>
-              <th>Severity</th>
               <th>Onset Date</th>
               <th>Recorded Date</th>
               <th>Resolved Date</th>
@@ -1851,7 +1939,6 @@ 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>
@@ -1868,13 +1955,13 @@ var PastHistoryOfIllnessTemplate = class {
 var PlanOfCareTemplate = class {
   /**
    * Generate HTML narrative for Plan of Care
-   * @param resource - FHIR Bundle containing CarePlan resources
+   * @param resources - FHIR CarePlan resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  generateNarrative(resource, timezone) {
-    const templateUtilities = new TemplateUtilities(resource);
-    const carePlans = resource.entry?.map((entry) => entry.resource) || [];
+  generateNarrative(resources, timezone) {
+    const templateUtilities = new TemplateUtilities(resources);
+    const carePlans = resources.map((entry) => entry) || [];
     carePlans.sort((a, b) => {
       const endA = a.period?.end ? new Date(a.period?.end).getTime() : 0;
       const endB = b.period?.end ? new Date(b.period?.end).getTime() : 0;
@@ -1913,37 +2000,35 @@ var PlanOfCareTemplate = class {
 var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
   /**
    * Generate HTML narrative for Functional Status
-   * @param resource - FHIR Bundle containing Observation resources
+   * @param resources - FHIR resources array containing Observation resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  generateNarrative(resource, timezone) {
-    return _FunctionalStatusTemplate.generateStaticNarrative(resource, timezone);
+  generateNarrative(resources, timezone) {
+    return _FunctionalStatusTemplate.generateStaticNarrative(resources, timezone);
   }
   /**
    * Internal static implementation that actually generates the narrative
-   * @param resource - FHIR Bundle containing Observation resources
+   * @param resources - FHIR resources array containing Observation resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  static generateStaticNarrative(resource, timezone) {
-    const templateUtilities = new TemplateUtilities(resource);
+  static generateStaticNarrative(resources, timezone) {
+    const templateUtilities = new TemplateUtilities(resources);
     let html = ``;
     const activeConditions = [];
     const clinicalImpressions = [];
-    if (resource.entry && Array.isArray(resource.entry)) {
-      for (const entry of resource.entry) {
-        if (entry.resource?.resourceType === "Condition") {
-          const cond = entry.resource;
-          const isResolved = cond.clinicalStatus?.coding?.some(
-            (c) => c.code === "resolved" || c.code === "inactive" || c.display?.toLowerCase().includes("resolved")
-          );
-          if (!isResolved) {
-            activeConditions.push(cond);
-          }
-        } else if (entry.resource?.resourceType === "ClinicalImpression") {
-          clinicalImpressions.push(entry.resource);
+    for (const resourceItem of resources) {
+      if (resourceItem.resourceType === "Condition") {
+        const cond = resourceItem;
+        const isResolved = cond.clinicalStatus?.coding?.some(
+          (c) => c.code === "resolved" || c.code === "inactive" || c.display?.toLowerCase().includes("resolved")
+        );
+        if (!isResolved) {
+          activeConditions.push(cond);
         }
+      } else if (resourceItem.resourceType === "ClinicalImpression") {
+        clinicalImpressions.push(resourceItem);
       }
     }
     activeConditions.sort((a, b) => {
@@ -1962,7 +2047,6 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
           <thead>
             <tr>
               <th>Problem</th>
-              <th>Severity</th>
               <th>Onset Date</th>
               <th>Recorded Date</th>
               <th>Notes</th>
@@ -1972,7 +2056,6 @@ 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>
@@ -2042,22 +2125,22 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
 var PregnancyTemplate = class _PregnancyTemplate {
   /**
    * Generate HTML narrative for Pregnancy
-   * @param resource - FHIR Bundle containing Observation resources
+   * @param resources - FHIR Observation resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  generateNarrative(resource, timezone) {
-    return _PregnancyTemplate.generateStaticNarrative(resource, timezone);
+  generateNarrative(resources, timezone) {
+    return _PregnancyTemplate.generateStaticNarrative(resources, timezone);
   }
   /**
    * Internal static implementation that actually generates the narrative
-   * @param resource - FHIR Bundle containing Observation resources
+   * @param resources - FHIR Observation resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  static generateStaticNarrative(resource, timezone) {
-    const templateUtilities = new TemplateUtilities(resource);
-    const observations = resource.entry?.map((entry) => entry.resource) || [];
+  static generateStaticNarrative(resources, timezone) {
+    const templateUtilities = new TemplateUtilities(resources);
+    const observations = resources.map((entry) => entry) || [];
     observations.sort((a, b) => {
       const dateA = a.effectiveDateTime || a.effectivePeriod?.start;
       const dateB = b.effectiveDateTime || b.effectivePeriod?.start;
@@ -2073,8 +2156,8 @@ var PregnancyTemplate = class _PregnancyTemplate {
             </tr>
           </thead>
           <tbody>`;
-    for (const resource2 of observations) {
-      const obs = resource2;
+    for (const resource of observations) {
+      const obs = resource;
       html += `
           <tr id="${templateUtilities.narrativeLinkId(obs)}">
             <td>${templateUtilities.extractPregnancyStatus(obs)}</td>
@@ -2093,29 +2176,27 @@ var PregnancyTemplate = class _PregnancyTemplate {
 var AdvanceDirectivesTemplate = class _AdvanceDirectivesTemplate {
   /**
    * Generate HTML narrative for Advance Directives
-   * @param resource - FHIR Bundle containing Advance Directive resources
+   * @param resources - FHIR Consent resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  generateNarrative(resource, timezone) {
-    if (resource.entry && Array.isArray(resource.entry)) {
-      resource.entry.sort((a, b) => {
-        const dateA = new Date(a.resource.dateTime || 0);
-        const dateB = new Date(b.resource.dateTime || 0);
-        return dateB.getTime() - dateA.getTime();
-      });
-    }
-    return _AdvanceDirectivesTemplate.generateStaticNarrative(resource, timezone);
+  generateNarrative(resources, timezone) {
+    resources.sort((a, b) => {
+      const dateA = new Date(a.dateTime || 0);
+      const dateB = new Date(b.dateTime || 0);
+      return dateB.getTime() - dateA.getTime();
+    });
+    return _AdvanceDirectivesTemplate.generateStaticNarrative(resources, timezone);
   }
   /**
    * Internal static implementation that actually generates the narrative
-   * @param resource - FHIR Bundle containing Advance Directive resources
+   * @param resources - FHIR Consent resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
   // eslint-disable-next-line @typescript-eslint/no-unused-vars
-  static generateStaticNarrative(resource, timezone) {
-    const templateUtilities = new TemplateUtilities(resource);
+  static generateStaticNarrative(resources, timezone) {
+    const templateUtilities = new TemplateUtilities(resources);
     let html = `
       <table>
         <thead>
@@ -2127,17 +2208,15 @@ var AdvanceDirectivesTemplate = class _AdvanceDirectivesTemplate {
           </tr>
         </thead>
         <tbody>`;
-    if (resource.entry && Array.isArray(resource.entry)) {
-      for (const entry of resource.entry) {
-        const consent = entry.resource;
-        html += `
-          <tr id="${templateUtilities.narrativeLinkId(consent)}">
-            <td>${templateUtilities.codeableConcept(consent.scope, "display")}</td>
-            <td>${consent.status || ""}</td>
-            <td>${consent.provision?.action ? templateUtilities.concatCodeableConcept(consent.provision.action) : ""}</td>
-            <td>${consent.dateTime || ""}</td>
-          </tr>`;
-      }
+    for (const resourceItem of resources) {
+      const consent = resourceItem;
+      html += `
+        <tr id="${templateUtilities.narrativeLinkId(consent)}">
+          <td>${templateUtilities.codeableConcept(consent.scope, "display")}</td>
+          <td>${consent.status || ""}</td>
+          <td>${consent.provision?.action ? templateUtilities.concatCodeableConcept(consent.provision.action) : ""}</td>
+          <td>${consent.dateTime || ""}</td>
+        </tr>`;
     }
     html += `
         </tbody>
@@ -2151,16 +2230,16 @@ var TypeScriptTemplateMapper = class {
   /**
    * Generates HTML narrative for a specific IPS section
    * @param section - The IPS section
-   * @param resource - FHIR Bundle containing resources
+   * @param resources - FHIR resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  static generateNarrative(section, resource, timezone) {
+  static generateNarrative(section, resources, timezone) {
     const templateClass = this.sectionToTemplate[section];
     if (!templateClass) {
       throw new Error(`No template found for section: ${section}`);
     }
-    return templateClass.generateNarrative(resource, timezone);
+    return templateClass.generateNarrative(resources, timezone);
   }
 };
 // Map of section types to their template classes
@@ -2223,14 +2302,7 @@ var NarrativeGenerator = class {
       return void 0;
     }
     try {
-      const bundle = {
-        resourceType: "Bundle",
-        type: "collection",
-        entry: resources.map((resource) => ({
-          resource
-        }))
-      };
-      const content = TypeScriptTemplateMapper.generateNarrative(section, bundle, timezone);
+      const content = TypeScriptTemplateMapper.generateNarrative(section, resources, timezone);
       if (!content) {
         return void 0;
       }
@@ -2315,13 +2387,16 @@ var ComprehensiveIPSCompositionBuilder = class {
   /**
    * sets the patient resource for the IPS Composition.
    * This is not needed if you are calling read_bundle, but can be used to set the patient resource directly.
-   * @param patient - FHIR Patient resource to set
+   * @param patients - FHIR Patient resource to set
    */
-  setPatient(patient) {
-    if (!patient || patient.resourceType !== "Patient") {
+  setPatient(patients) {
+    if (!Array.isArray(patients)) {
+      patients = [patients];
+    }
+    if (patients.length === 0 || !patients.every((patient) => patient.resourceType === "Patient")) {
       throw new Error("Invalid Patient resource");
     }
-    this.patient = patient;
+    this.patients = patients;
     return this;
   }
   /**
@@ -2379,21 +2454,26 @@ var ComprehensiveIPSCompositionBuilder = class {
     if (!bundle.entry) {
       return this;
     }
-    const patientEntry = bundle.entry.find((e) => e.resource?.resourceType === "Patient");
-    if (!patientEntry || !patientEntry.resource) {
+    const patientEntries = [];
+    const resources = [];
+    bundle.entry.forEach((e) => {
+      if (e.resource?.resourceType === "Patient") {
+        patientEntries.push(e.resource);
+        this.resources.add(e.resource);
+      } else if (e.resource) {
+        resources.push(e.resource);
+      }
+    });
+    if (patientEntries.length === 0) {
       throw new Error("Patient resource not found in the bundle");
     }
-    this.patient = patientEntry.resource;
-    const resources = bundle.entry.map((e) => e.resource);
+    this.patients = patientEntries;
     for (const sectionType of Object.values(IPSSections)) {
-      const resourceTypesForSection = IPSSectionResourceHelper.getResourceTypesForSection(sectionType);
-      const customFilter = IPSSectionResourceHelper.getResourceFilterForSection(sectionType);
-      let sectionResources = resources.filter(
-        (r) => r && typeof r.resourceType === "string" && resourceTypesForSection.includes(r.resourceType)
-      );
-      if (customFilter) {
-        sectionResources = sectionResources.filter((resource) => resource && customFilter(resource));
+      if (sectionType === "Patient" /* PATIENT */) {
+        continue;
       }
+      const sectionFilter = IPSSectionResourceHelper.getResourceFilterForSection(sectionType);
+      const sectionResources = resources.filter((resource) => sectionFilter(resource));
       await this.addSectionAsync(sectionType, sectionResources, timezone);
     }
     return this;
@@ -2404,16 +2484,18 @@ var ComprehensiveIPSCompositionBuilder = class {
    * @param authorOrganizationName - Name of the authoring organization
    * @param baseUrl - Base URL for the FHIR server (e.g., 'https://example.com/fhir')
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
+   * @param patientId - Optional patient ID to use as primary patient for composition reference
    */
-  async buildBundleAsync(authorOrganizationId, authorOrganizationName, baseUrl, timezone) {
+  async buildBundleAsync(authorOrganizationId, authorOrganizationName, baseUrl, timezone, patientId) {
     if (baseUrl.endsWith("/")) {
       baseUrl = baseUrl.slice(0, -1);
     }
-    if (!this.patient) {
+    if (!this.patients) {
       throw new Error("Patient resource must be set before building the bundle");
     }
+    const primaryPatientId = patientId ?? this.patients[0].id;
     const composition = {
-      id: `Composition-${this.patient.id}`,
+      id: `Composition-${primaryPatientId}`,
       resourceType: "Composition",
       status: "final",
       type: {
@@ -2424,7 +2506,7 @@ var ComprehensiveIPSCompositionBuilder = class {
         }]
       },
       subject: {
-        reference: `Patient/${this.patient.id}`
+        reference: `Patient/${primaryPatientId}`
       },
       author: [{
         reference: `Organization/${authorOrganizationId}`,
@@ -2436,7 +2518,7 @@ var ComprehensiveIPSCompositionBuilder = class {
       section: this.sections,
       text: await NarrativeGenerator.generateNarrativeAsync(
         "Patient" /* PATIENT */,
-        [this.patient],
+        this.patients,
         timezone,
         true
       )
@@ -2455,9 +2537,11 @@ var ComprehensiveIPSCompositionBuilder = class {
       fullUrl: `${baseUrl}/Composition/${composition.id}`,
       resource: composition
     });
-    bundle.entry?.push({
-      fullUrl: `${baseUrl}/Patient/${this.patient.id}`,
-      resource: this.patient
+    this.patients.forEach((patient) => {
+      bundle.entry?.push({
+        fullUrl: `${baseUrl}/Patient/${patient.id}`,
+        resource: patient
+      });
     });
     this.resources.forEach((resource) => {
       if (resource.resourceType !== "Patient") {