@imranq2/fhirpatientsummary 1.0.16 → 1.0.18

package/dist/index.js

@@ -82,33 +82,21 @@ var BLOOD_PRESSURE_LOINC_CODES = {
 };
 
 // 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
@@ -124,28 +112,30 @@ 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 IPSSectionSummaryCompositionFilter = {
+  ["AllergyIntoleranceSection" /* ALLERGIES */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => c.system === "https://fhir.icanbwell.com/4_0_0/CodeSystem/composition/" && c.code === "allergy_summary_document"),
+  ["VitalSignsSection" /* VITAL_SIGNS */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => c.system === "https://fhir.icanbwell.com/4_0_0/CodeSystem/composition/" && c.code === "vital_summary_document")
 };
 var IPSSectionResourceHelper = class {
-  static getResourceTypesForSection(section) {
-    return IPSSectionResourceMap[section] || [];
-  }
   static getResourceFilterForSection(section) {
     return IPSSectionResourceFilters[section];
   }
+  static getSummaryCompositionFilterForSection(section) {
+    return IPSSectionSummaryCompositionFilter[section];
+  }
 };
 
 // src/narratives/templates/typescript/TemplateUtilities.ts
 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
@@ -176,7 +166,7 @@ var TemplateUtilities = class {
     return "";
   }
   resolveReference(ref) {
-    if (!ref || !this.bundle || !this.bundle.entry) {
+    if (!ref || !this.resources) {
       return null;
     }
     const referenceParts = ref.reference?.split("/");
@@ -185,10 +175,10 @@ 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
@@ -584,6 +574,137 @@ var TemplateUtilities = class {
     }
     return status;
   }
+  extractObservationSummaryValue(data, timezone) {
+    if (data["valueQuantity.value"] !== void 0) {
+      const value = data["valueQuantity.value"];
+      const unit = data["valueQuantity.unit"];
+      return unit ? `${value} ${unit}` : `${value}`;
+    }
+    if (data["valueCodeableConcept.text"] !== void 0) {
+      return data["valueCodeableConcept.text"];
+    }
+    if (data["valueCodeableConcept.coding.display"] !== void 0) {
+      return data["valueCodeableConcept.coding.display"];
+    }
+    if (data["valueString"] !== void 0) {
+      return data["valueString"];
+    }
+    if (data["valueBoolean"] !== void 0) {
+      return String(data["valueBoolean"]);
+    }
+    if (data["valueInteger"] !== void 0) {
+      return String(data["valueInteger"]);
+    }
+    if (data["valueDateTime"] !== void 0) {
+      return this.renderTime(data["valueDateTime"], timezone);
+    }
+    if (data["valuePeriod.start"] !== void 0 || data["valuePeriod.end"] !== void 0) {
+      const start = this.renderTime(data["valuePeriod.start"], timezone);
+      const end = this.renderTime(data["valuePeriod.end"], timezone);
+      if (start && end) {
+        return `${start} - ${end}`;
+      } else if (start) {
+        return `${start}`;
+      } else if (end) {
+        return `${end}`;
+      }
+    }
+    if (data["valueTime"] !== void 0) {
+      return this.renderTime(data["valueTime"], timezone);
+    }
+    if (data["valueSampledData.origin.value"] !== void 0 || data["valueSampledData.origin.unit"] !== void 0) {
+      const originValue = data["valueSampledData.origin.value"];
+      const originUnit = data["valueSampledData.origin.unit"];
+      let result = "";
+      if (originValue !== void 0 && originUnit !== void 0) {
+        result = `${originValue} ${originUnit}`;
+      } else if (originValue !== void 0) {
+        result = `${originValue}`;
+      } else if (originUnit !== void 0) {
+        result = `${originUnit}`;
+      }
+      const period = data["valueSampledData.period"];
+      const factor = data["valueSampledData.factor"];
+      const lowerLimit = data["valueSampledData.lowerLimit"];
+      const upperLimit = data["valueSampledData.upperLimit"];
+      const sampledData = data["valueSampledData.data"];
+      const extras = [];
+      if (period !== void 0) extras.push(`period: ${period}`);
+      if (factor !== void 0) extras.push(`factor: ${factor}`);
+      if (lowerLimit !== void 0) extras.push(`lowerLimit: ${lowerLimit}`);
+      if (upperLimit !== void 0) extras.push(`upperLimit: ${upperLimit}`);
+      if (sampledData !== void 0) extras.push(`data: ${sampledData}`);
+      if (extras.length > 0) {
+        result += ` (${extras.join(", ")})`;
+      }
+      return result;
+    }
+    if (data["valueRange.low.value"] !== void 0 || data["valueRange.high.value"] !== void 0) {
+      let referenceRange = "";
+      if (data["valueRange.low.value"] !== void 0) {
+        referenceRange += `${data["valueRange.low.value"]}`;
+        if (data["valueRange.low.unit"] !== void 0) {
+          referenceRange += ` ${data["valueRange.low.unit"]}`;
+        }
+        referenceRange = referenceRange.trim();
+        if (data["valueRange.high.value"] !== void 0) {
+          referenceRange += " - ";
+        }
+      }
+      if (data["valueRange.high.value"] !== void 0) {
+        referenceRange += `${data["valueRange.high.value"]}`;
+        if (data["valueRange.high.unit"] !== void 0) {
+          referenceRange += ` ${data["valueRange.high.unit"]}`;
+        }
+      }
+      return referenceRange.trim();
+    }
+    if (data["valueRatio.numerator.value"] !== void 0 || data["valueRatio.denominator.value"] !== void 0) {
+      let ratio = "";
+      if (data["valueRatio.numerator.value"] !== void 0) {
+        ratio += `${data["valueRatio.numerator.value"]}`;
+        if (data["valueRatio.numerator.unit"] !== void 0) {
+          ratio += ` ${data["valueRatio.numerator.unit"]}`;
+        }
+      }
+      if (data["valueRatio.denominator.value"] !== void 0) {
+        ratio += " / ";
+        ratio += `${data["valueRatio.denominator.value"]}`;
+        if (data["valueRatio.denominator.unit"] !== void 0) {
+          ratio += ` ${data["valueRatio.denominator.unit"]}`;
+        }
+      }
+      return ratio.trim();
+    }
+    return "";
+  }
+  extractObservationSummaryReferenceRange(data) {
+    let referenceRange = "";
+    if (data["referenceRange.low.value"]) {
+      referenceRange += `${data["referenceRange.low.value"]} ${data["referenceRange.low.unit"]}`;
+      referenceRange.trim();
+      if (data["referenceRange.high.value"]) {
+        referenceRange += " - ";
+      }
+    }
+    if (data["referenceRange.high.value"]) {
+      referenceRange += `${data["referenceRange.high.value"]} ${data["referenceRange.high.unit"]}`;
+    }
+    return referenceRange.trim();
+  }
+  extractObservationSummaryEffectiveTime(data, timezone) {
+    if (data["effectiveDateTime"]) {
+      return this.renderTime(data["effectiveDateTime"], timezone);
+    }
+    let effectiveTimePeriod = "";
+    if (data["effectivePeriod.start"]) {
+      effectiveTimePeriod += this.renderTime(data["effectivePeriod.start"], timezone);
+    }
+    if (data["effectivePeriod.end"]) {
+      effectiveTimePeriod += ` - ${this.renderTime(data["effectivePeriod.end"], timezone)}`;
+    }
+    return effectiveTimePeriod.trim();
+  }
   formatQuantityValue(quantity) {
     if (!quantity) return "";
     const parts = [];
@@ -759,7 +880,7 @@ var TemplateUtilities = class {
       if (parts.length === 2) {
         const resourceType = parts[0];
         const resourceId = parts[1];
-        const resource = this.bundle.entry?.find((entry) => entry.resource?.resourceType === resourceType && entry.resource?.id === resourceId);
+        const resource = this.resources?.find((resource2) => resource2.resourceType === resourceType && resource2.id === resourceId);
         if (resource) {
           return `${resourceType}/${resourceId}`;
         }
@@ -799,48 +920,96 @@ var TemplateUtilities = class {
 // src/narratives/templates/typescript/PatientTemplate.ts
 var PatientTemplate = class _PatientTemplate {
   /**
-   * Generate HTML narrative for Patient resource
-   * @param resource - FHIR Bundle containing Patient resource
+   * Generate HTML narrative for Patient resources
+   * @param resources - FHIR Patient resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  generateNarrative(resource, timezone) {
-    return _PatientTemplate.generateStaticNarrative(resource, timezone);
+  generateNarrative(resources, timezone) {
+    return _PatientTemplate.generateStaticNarrative(resources, timezone);
   }
   /**
    * Internal static implementation that actually generates the narrative
-   * @param resource - FHIR Bundle containing Patient resource
+   * @param resources - FHIR Patient resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
   // eslint-disable-next-line @typescript-eslint/no-unused-vars
-  static generateStaticNarrative(resource, timezone) {
-    const templateUtilities = new TemplateUtilities(resource);
-    let html = "";
-    for (const entry of resource.entry || []) {
-      if (entry.resource?.resourceType === "Patient") {
-        const patient = entry.resource;
-        html += `
-        <div>
-          <ul>
-            <li><strong>Name(s):</strong>${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) {
@@ -860,7 +1029,7 @@ var PatientTemplate = class _PatientTemplate {
   }
   /**
    * Renders patient identifiers as HTML list items
-   * @param patient - Patient resource
+   * @param patient - Patient resources
    * @returns HTML string of list items
    */
   static renderIdentifiers(patient) {
@@ -875,7 +1044,7 @@ 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) {
@@ -934,7 +1103,7 @@ 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) {
@@ -956,9 +1125,18 @@ var PatientTemplate = class _PatientTemplate {
         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) {
@@ -969,7 +1147,7 @@ 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) {
@@ -984,7 +1162,7 @@ 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) {
@@ -1019,32 +1197,81 @@ 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);
+  }
+  /**
+   * Generate HTML narrative for AllergyIntolerance resources using summary
+   * @param resources - FHIR Composition resources
+   * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
+   * @returns HTML string for rendering
+   */
+  generateSummaryNarrative(resources, timezone) {
+    const templateUtilities = new TemplateUtilities(resources);
+    let html = `
+      <div>
+        <table>
+          <thead>
+            <tr>
+              <th>Allergen</th>
+              <th>Criticality</th>
+              <th>Recorded Date</th>
+            </tr>
+          </thead>
+          <tbody>`;
+    for (const resourceItem of resources) {
+      for (const rowData of resourceItem.section ?? []) {
+        const data = {};
+        for (const columnData of rowData.section ?? []) {
+          switch (columnData.title) {
+            case "Allergen Name":
+              data["allergen"] = columnData.text?.div ?? "";
+              break;
+            case "Criticality":
+              data["criticality"] = columnData.text?.div ?? "";
+              break;
+            case "Recorded Date":
+              data["recordedDate"] = columnData.text?.div ?? "";
+              break;
+            default:
+              break;
+          }
+        }
+        html += `
+            <tr>
+              <td>${data["allergen"] ?? "-"}</td>
+              <td>${data["criticality"] ?? "-"}</td>
+              <td>${templateUtilities.renderTime(data["recordedDate"], timezone) ?? "-"}</td>
+            </tr>`;
+      }
+    }
+    html += `
+          </tbody>
+        </table>
+      </div>`;
+    return html;
   }
   /**
    * 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) => {
@@ -1157,12 +1384,12 @@ 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
@@ -1227,16 +1454,16 @@ 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) => {
@@ -1290,33 +1517,33 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
     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)
     }));
   }
   /**
@@ -1412,28 +1639,26 @@ 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>
@@ -1448,21 +1673,20 @@ 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 += `
@@ -1476,23 +1700,23 @@ 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;
@@ -1523,26 +1747,95 @@ var ProblemListTemplate = class _ProblemListTemplate {
   }
 };
 
+// src/structures/ips_section_constants.ts
+var VITAL_SIGNS_SUMMARY_COMPONENT_MAP = {
+  "Systolic Blood Pressure": "valueRatio.numerator.value",
+  "Diastolic Blood Pressure": "valueRatio.denominator.value",
+  "Default": "valueString"
+};
+
 // src/narratives/templates/typescript/VitalSignsTemplate.ts
 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);
+  }
+  /**
+   * Generate HTML narrative for vital signs using summary
+   * @param resources - FHIR Composition resources
+   * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
+   * @returns HTML string for rendering
+   */
+  generateSummaryNarrative(resources, timezone) {
+    const templateUtilities = new TemplateUtilities(resources);
+    let html = `
+      <div>
+        <table>
+          <thead>
+            <tr>
+              <th>Vital Name</th>
+              <th>Result</th>
+              <th>Reference Range</th>
+              <th>Date</th>
+            </tr>
+          </thead>
+          <tbody>`;
+    for (const resourceItem of resources) {
+      for (const rowData of resourceItem.section ?? []) {
+        const data = {};
+        for (const columnData of rowData.section ?? []) {
+          const columnTitle = columnData.title;
+          if (columnTitle) {
+            if (Object.keys(VITAL_SIGNS_SUMMARY_COMPONENT_MAP).includes(
+              columnTitle
+            )) {
+              const vitalData = {};
+              for (const component of columnData.section?.[0]?.section ?? []) {
+                if (component.title) {
+                  vitalData[component.title] = component.text?.div ?? "";
+                }
+              }
+              const vitalValue = templateUtilities.extractObservationSummaryValue(
+                vitalData,
+                timezone
+              );
+              if (vitalValue) {
+                const dataKey = VITAL_SIGNS_SUMMARY_COMPONENT_MAP[columnTitle] ?? VITAL_SIGNS_SUMMARY_COMPONENT_MAP["Default"];
+                data[dataKey] = vitalValue;
+              }
+            }
+            data[columnTitle] = columnData.text?.div ?? "";
+          }
+        }
+        html += `
+          <tr>
+            <td>${data["Vital Name"] ?? "-"}</td>
+            <td>${templateUtilities.extractObservationSummaryValue(data, timezone) ?? "-"}</td>
+            <td>${templateUtilities.extractObservationSummaryReferenceRange(data) ?? "-"}</td>
+            <td>${templateUtilities.extractObservationSummaryEffectiveTime(data, timezone) ?? "-"}</td>
+          </tr>`;
+      }
+    }
+    html += `
+          </tbody>
+        </table>
+      </div>`;
+    return html;
   }
   /**
    * 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;
@@ -1552,7 +1845,7 @@ var VitalSignsTemplate = class _VitalSignsTemplate {
       <table>
         <thead>
           <tr>
-            <th>Code</th>
+            <th>Vital Name</th>
             <th>Result</th>
             <th>Unit</th>
             <th>Interpretation</th>
@@ -1585,28 +1878,21 @@ 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>
@@ -1618,19 +1904,19 @@ 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>
@@ -1643,23 +1929,23 @@ 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;
@@ -1668,7 +1954,7 @@ 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;
@@ -1680,26 +1966,20 @@ 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
@@ -1785,26 +2065,26 @@ 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>
@@ -1815,16 +2095,14 @@ 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>
@@ -1837,22 +2115,22 @@ 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;
@@ -1891,14 +2169,14 @@ 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;
@@ -1935,13 +2213,13 @@ 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;
@@ -1980,37 +2258,35 @@ 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) => {
@@ -2107,22 +2383,22 @@ 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;
@@ -2138,8 +2414,8 @@ 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>
@@ -2158,29 +2434,27 @@ 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>
@@ -2192,17 +2466,15 @@ 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>
@@ -2216,16 +2488,20 @@ 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')
+   * @param useSectionSummary - Whether to use the section summary for narrative generation
    * @returns HTML string for rendering
    */
-  static generateNarrative(section, resource, timezone) {
+  static generateNarrative(section, resources, timezone, useSectionSummary = false) {
     const templateClass = this.sectionToTemplate[section];
     if (!templateClass) {
       throw new Error(`No template found for section: ${section}`);
     }
-    return templateClass.generateNarrative(resource, timezone);
+    return useSectionSummary ? templateClass.generateSummaryNarrative(
+      resources,
+      timezone
+    ) : templateClass.generateNarrative(resources, timezone);
   }
 };
 // Map of section types to their template classes
@@ -2281,21 +2557,15 @@ var NarrativeGenerator = class {
    * @param section - IPS section type
    * @param resources - Array of domain resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
+   * @param useSectionSummary - Whether to use section summary for narrative generation (default: false)
    * @returns Generated HTML content or undefined if no resources
    */
-  static async generateNarrativeContentAsync(section, resources, timezone) {
+  static async generateNarrativeContentAsync(section, resources, timezone, useSectionSummary = false) {
     if (!resources || resources.length === 0) {
       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, useSectionSummary);
       if (!content) {
         return void 0;
       }
@@ -2346,10 +2616,11 @@ var NarrativeGenerator = class {
    * @param resources - Array of domain resources
    * @param timezone - Optional timezone to use for date formatting
    * @param minify - Whether to minify the HTML content (default: true)
+   * @param useSectionSummary - Whether to use section summary for narrative generation (default: false)
    * @returns Promise that resolves to a FHIR Narrative object or undefined if no resources
    */
-  static async generateNarrativeAsync(section, resources, timezone, minify = true) {
-    const content = await this.generateNarrativeContentAsync(section, resources, timezone);
+  static async generateNarrativeAsync(section, resources, timezone, minify = true, useSectionSummary = false) {
+    const content = await this.generateNarrativeContentAsync(section, resources, timezone, useSectionSummary);
     if (!content) {
       return void 0;
     }
@@ -2380,22 +2651,51 @@ 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;
   }
   /**
    * Adds a section to the composition with async HTML minification
+   * @param narrative - Narrative content for the section
+   * @param sectionType - IPS section type
+   * @param validResources - Array of domain resources
+   */
+  addSectionAsync(narrative, sectionType, validResources) {
+    const sectionEntry = {
+      title: IPS_SECTION_DISPLAY_NAMES[sectionType] || sectionType,
+      code: {
+        coding: [{
+          system: "http://loinc.org",
+          code: IPS_SECTION_LOINC_CODES[sectionType],
+          display: IPS_SECTION_DISPLAY_NAMES[sectionType] || sectionType
+        }],
+        text: IPS_SECTION_DISPLAY_NAMES[sectionType] || sectionType
+      },
+      text: narrative,
+      entry: validResources.map((resource) => ({
+        reference: `${resource.resourceType}/${resource.id}`,
+        display: resource.resourceType
+      }))
+    };
+    this.sections.push(sectionEntry);
+    return this;
+  }
+  /**
+   * Make and adds a section to the composition with async HTML minification
    * @param sectionType - IPS section type
    * @param validResources - Array of domain resources
    * @param timezone - Optional timezone to use for date formatting
    */
-  async addSectionAsync(sectionType, validResources, timezone) {
+  async makeSectionAsync(sectionType, validResources, timezone) {
     for (const resource of validResources) {
       this.resources.add(resource);
     }
@@ -2415,51 +2715,68 @@ var ComprehensiveIPSCompositionBuilder = class {
       } else {
         return this;
       }
-      const sectionEntry = {
-        title: IPS_SECTION_DISPLAY_NAMES[sectionType] || sectionType,
-        code: {
-          coding: [{
-            system: "http://loinc.org",
-            code: IPS_SECTION_LOINC_CODES[sectionType],
-            display: IPS_SECTION_DISPLAY_NAMES[sectionType] || sectionType
-          }],
-          text: IPS_SECTION_DISPLAY_NAMES[sectionType] || sectionType
-        },
-        text: narrative,
-        entry: validResources.map((resource) => ({
-          reference: `${resource.resourceType}/${resource.id}`,
-          display: resource.resourceType
-        }))
-      };
-      this.sections.push(sectionEntry);
+      this.addSectionAsync(narrative, sectionType, validResources);
     }
     return this;
   }
+  async makeSectionFromSummaryAsync(sectionType, summaryCompositions, resources, timezone) {
+    const sectionResources = [];
+    for (const summaryComposition of summaryCompositions) {
+      const resourceEntries = summaryComposition?.section?.flatMap((sec) => sec.entry || []) ?? [];
+      resources.forEach((resource) => {
+        if (resourceEntries?.some((entry) => entry.reference === `${resource.resourceType}/${resource.id}`)) {
+          this.resources.add(resource);
+          sectionResources.push(resource);
+        }
+      });
+    }
+    const narrative = await NarrativeGenerator.generateNarrativeAsync(
+      sectionType,
+      summaryCompositions,
+      timezone,
+      true,
+      true
+    );
+    this.addSectionAsync(narrative, sectionType, sectionResources);
+    return this;
+  }
   /**
    * Reads a FHIR Bundle and extracts resources for each section defined in IPSSections.
    * @param bundle - FHIR Bundle containing resources
    * @param timezone - Optional timezone to use for date formatting
+   * @param useSummaryCompositions - Whether to use summary compositions (default: false)
    */
-  async readBundleAsync(bundle, timezone) {
+  async readBundleAsync(bundle, timezone, useSummaryCompositions = false) {
     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 summaryCompositionFilter = useSummaryCompositions ? IPSSectionResourceHelper.getSummaryCompositionFilterForSection(sectionType) : void 0;
+      const sectionSummary = summaryCompositionFilter ? resources.filter((resource) => summaryCompositionFilter(resource)) : void 0;
+      if (sectionSummary) {
+        await this.makeSectionFromSummaryAsync(sectionType, sectionSummary, resources, timezone);
+      } else {
+        const sectionFilter = IPSSectionResourceHelper.getResourceFilterForSection(sectionType);
+        const sectionResources = resources.filter((resource) => sectionFilter(resource));
+        await this.makeSectionAsync(sectionType, sectionResources, timezone);
       }
-      await this.addSectionAsync(sectionType, sectionResources, timezone);
     }
     return this;
   }
@@ -2469,16 +2786,18 @@ 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-${primaryPatientId}`,
       resourceType: "Composition",
       status: "final",
       type: {
@@ -2489,7 +2808,7 @@ var ComprehensiveIPSCompositionBuilder = class {
         }]
       },
       subject: {
-        reference: `Patient/${this.patient.id}`
+        reference: `Patient/${primaryPatientId}`
       },
       author: [{
         reference: `Organization/${authorOrganizationId}`,
@@ -2501,7 +2820,7 @@ var ComprehensiveIPSCompositionBuilder = class {
       section: this.sections,
       text: await NarrativeGenerator.generateNarrativeAsync(
         "Patient" /* PATIENT */,
-        [this.patient],
+        this.patients,
         timezone,
         true
       )
@@ -2520,9 +2839,11 @@ 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") {