@imranq2/fhirpatientsummary 1.0.22 → 1.0.24

package/dist/index.js

@@ -81,6 +81,14 @@ var BLOOD_PRESSURE_LOINC_CODES = {
   DIASTOLIC: "8462-4"
 };
 
+// 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"
+};
+var IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM = "https://fhir.icanbwell.com/4_0_0/CodeSystem/composition/";
+
 // src/structures/ips_section_resource_map.ts
 var IPSSectionResourceFilters = {
   // Patient section: only Patient resource
@@ -88,7 +96,7 @@ var IPSSectionResourceFilters = {
   // 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),
+  ["MedicationSummarySection" /* MEDICATIONS */]: (resource) => ["MedicationRequest", "MedicationStatement"].includes(resource.resourceType) && resource.status === "active" || resource.resourceType === "Medication",
   // Only include active conditions
   ["ProblemSection" /* PROBLEMS */]: (resource) => resource.resourceType === "Condition" && resource.clinicalStatus?.coding?.some((c) => !["inactive", "resolved"].includes(c.code)),
   // Only include completed immunizations
@@ -115,10 +123,13 @@ var IPSSectionResourceFilters = {
   ["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"),
-  ["PlanOfCareSection" /* CARE_PLAN */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => c.system === "https://fhir.icanbwell.com/4_0_0/CodeSystem/composition/" && c.code === "careplan_summary_document"),
-  ["ImmunizationSection" /* IMMUNIZATIONS */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => c.system === "https://fhir.icanbwell.com/4_0_0/CodeSystem/composition/" && c.code === "immunization_summary_document")
+  ["AllergyIntoleranceSection" /* ALLERGIES */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => c.system === IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM && c.code === "allergy_summary_document"),
+  ["VitalSignsSection" /* VITAL_SIGNS */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => c.system === IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM && c.code === "vital_summary_document"),
+  ["PlanOfCareSection" /* CARE_PLAN */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => c.system === IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM && c.code === "careplan_summary_document"),
+  ["ImmunizationSection" /* IMMUNIZATIONS */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => c.system === IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM && c.code === "immunization_summary_document"),
+  ["MedicationSummarySection" /* MEDICATIONS */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => c.system === IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM && c.code === "medication_summary_document"),
+  ["ResultsSection" /* DIAGNOSTIC_REPORTS */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => c.system === IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM && ["lab_summary_document", "diagnosticreportlab_summary_document"].includes(c.code)),
+  ["HistoryOfProceduresSection" /* PROCEDURES */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => c.system === IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM && c.code === "procedure_summary_document")
 };
 var IPSSectionResourceHelper = class {
   static getResourceFilterForSection(section) {
@@ -822,9 +833,11 @@ var TemplateUtilities = class {
       if (dateValue instanceof Date) {
         dateTime = DateTime.fromJSDate(dateValue);
       } else if (typeof dateValue === "string") {
-        dateTime = DateTime.fromISO(dateValue);
         if (!dateValue.includes("T")) {
           dateOnly = true;
+          dateTime = DateTime.fromISO(dateValue, { zone: "utc" });
+        } else {
+          dateTime = DateTime.fromISO(dateValue);
         }
       } else {
         dateTime = DateTime.fromISO(String(dateValue));
@@ -926,6 +939,9 @@ var TemplateUtilities = class {
   }
 };
 
+// src/constants.ts
+var ADDRESS_SIMILARITY_THRESHOLD = 70;
+
 // src/narratives/templates/typescript/PatientTemplate.ts
 var PatientTemplate = class _PatientTemplate {
   /**
@@ -952,7 +968,6 @@ var PatientTemplate = class _PatientTemplate {
         <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> ${combinedPatient.maritalStatus?.text || ""}</li>
@@ -973,7 +988,6 @@ var PatientTemplate = class _PatientTemplate {
     }
     const combined = patients[0];
     const allNames = [];
-    const allIdentifiers = [];
     const allTelecom = [];
     const allAddresses = [];
     const allCommunication = [];
@@ -981,9 +995,6 @@ var PatientTemplate = class _PatientTemplate {
       if (patient.name) {
         allNames.push(...patient.name);
       }
-      if (patient.identifier) {
-        allIdentifiers.push(...patient.identifier);
-      }
       if (patient.telecom) {
         allTelecom.push(...patient.telecom);
       }
@@ -1010,7 +1021,6 @@ var PatientTemplate = class _PatientTemplate {
       }
     });
     combined.name = allNames;
-    combined.identifier = allIdentifiers;
     combined.telecom = allTelecom;
     combined.address = allAddresses;
     combined.communication = allCommunication;
@@ -1036,21 +1046,6 @@ var PatientTemplate = class _PatientTemplate {
     });
     return Array.from(uniqueNames).map((nameText) => `<ul><li>${nameText}</li></ul>`).join("");
   }
-  /**
-   * Renders patient identifiers as HTML list items
-   * @param patient - Patient resources
-   * @returns HTML string of list items
-   */
-  static renderIdentifiers(patient) {
-    if (!patient.identifier || patient.identifier.length === 0) {
-      return "";
-    }
-    return patient.identifier.map((id) => {
-      const system = id.system || "";
-      const value = id.value || "";
-      return `<ul><li>${system}: ${value}</li></ul>`;
-    }).join("");
-  }
   /**
    * Renders patient telecom information grouped by system
    * @param patient - Patient resources
@@ -1152,7 +1147,89 @@ var PatientTemplate = class _PatientTemplate {
         uniqueAddresses.add(addressText);
       }
     });
-    return Array.from(uniqueAddresses).map((addressText) => `<ul><li>${addressText}</li></ul>`).join("");
+    const deduplicatedAddresses = this.deduplicateSimilarAddresses(Array.from(uniqueAddresses));
+    return deduplicatedAddresses.map((addressText) => `<ul><li>${addressText}</li></ul>`).join("");
+  }
+  /**
+   * Calculates the similarity between two strings using Levenshtein distance
+   * Returns a percentage (0-100) indicating how similar the strings are
+   * @param str1 - First string
+   * @param str2 - Second string
+   * @returns Similarity percentage (0-100)
+   */
+  static calculateStringSimilarity(str1, str2) {
+    const longer = str1.length > str2.length ? str1 : str2;
+    const shorter = str1.length > str2.length ? str2 : str1;
+    if (longer.length === 0) {
+      return 100;
+    }
+    const editDistance = this.levenshteinDistance(longer.toLowerCase(), shorter.toLowerCase());
+    return (longer.length - editDistance) / longer.length * 100;
+  }
+  /**
+   * Calculates the Levenshtein distance between two strings
+   * @param str1 - First string
+   * @param str2 - Second string
+   * @returns The Levenshtein distance
+   */
+  static levenshteinDistance(str1, str2) {
+    const matrix = [];
+    for (let i = 0; i <= str2.length; i++) {
+      matrix[i] = [i];
+    }
+    for (let j = 0; j <= str1.length; j++) {
+      matrix[0][j] = j;
+    }
+    for (let i = 1; i <= str2.length; i++) {
+      for (let j = 1; j <= str1.length; j++) {
+        if (str2.charAt(i - 1) === str1.charAt(j - 1)) {
+          matrix[i][j] = matrix[i - 1][j - 1];
+        } else {
+          matrix[i][j] = Math.min(
+            matrix[i - 1][j - 1] + 1,
+            // substitution
+            matrix[i][j - 1] + 1,
+            // insertion
+            matrix[i - 1][j] + 1
+            // deletion
+          );
+        }
+      }
+    }
+    return matrix[str2.length][str1.length];
+  }
+  /**
+   * Deduplicates addresses that are more than ADDRESS_SIMILARITY_THRESHOLD% similar
+   * @param addresses - Array of address strings
+   * @returns Array of deduplicated addresses
+   */
+  static deduplicateSimilarAddresses(addresses) {
+    if (addresses.length <= 1) {
+      return addresses;
+    }
+    const deduplicated = [];
+    const processed = /* @__PURE__ */ new Set();
+    for (let i = 0; i < addresses.length; i++) {
+      if (processed.has(i)) {
+        continue;
+      }
+      let keepAddress = addresses[i];
+      processed.add(i);
+      for (let j = i + 1; j < addresses.length; j++) {
+        if (processed.has(j)) {
+          continue;
+        }
+        const similarity = this.calculateStringSimilarity(addresses[i], addresses[j]);
+        if (similarity > ADDRESS_SIMILARITY_THRESHOLD) {
+          processed.add(j);
+          if (addresses[j].length > keepAddress.length) {
+            keepAddress = addresses[j];
+          }
+        }
+      }
+      deduplicated.push(keepAddress);
+    }
+    return deduplicated;
   }
   /**
    * Renders patient deceased status
@@ -1400,6 +1477,75 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
   generateNarrative(resources, timezone) {
     return _MedicationSummaryTemplate.generateStaticNarrative(resources, timezone);
   }
+  /**
+   * Generate HTML narrative for Medication 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>Medication</th>
+                <th>Sig</th>
+                <th>Days of Supply</th>
+                <th>Refills</th>
+                <th>Start 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 "Medication Name":
+              data["medication"] = columnData.text?.div ?? "";
+              break;
+            case "Status":
+              data["status"] = columnData.text?.div ?? "";
+              break;
+            case "Prescriber Instruction":
+              data["sig-prescriber"] = columnData.text?.div ?? "";
+              break;
+            case "Pharmacy Instruction":
+              data["sig-pharmacy"] = columnData.text?.div ?? "";
+              break;
+            case "Days Of Supply":
+              data["daysOfSupply"] = columnData.text?.div ?? "";
+              break;
+            case "Refills Remaining":
+              data["refills"] = columnData.text?.div ?? "";
+              break;
+            case "Authored On Date":
+              data["startDate"] = columnData.text?.div ?? "";
+              break;
+            default:
+              break;
+          }
+        }
+        if (data["status"] === "active") {
+          html += `
+                    <tr>
+                        <td>${data["medication"]}</td>
+                        <td>${data["sig-prescriber"] || data["sig-pharmacy"]}</td>
+                        <td>${data["daysOfSupply"]}</td>
+                        <td>${data["refills"]}</td>
+                        <td>${templateUtilities.renderTime(data["startDate"], timezone)}</td>
+                    </tr>`;
+        }
+      }
+    }
+    html += `
+            </tbody>
+            </table>
+        </div>`;
+    return html;
+  }
   /**
    * Safely parse a date string and return a valid Date object or null
    * @param dateString - The date string to parse
@@ -1412,55 +1558,6 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
     const date = new Date(dateString);
     return !isNaN(date.getTime()) ? date : null;
   }
-  /**
-   * Determine if a MedicationRequest is active
-   * @param medicationRequest - The MedicationRequest resource
-   * @returns boolean indicating if the medication request is active
-   */
-  static isActiveMedicationRequest(medicationRequest) {
-    const status = medicationRequest.status?.toLowerCase();
-    if (status === "active" || status === "unknown") {
-      return true;
-    }
-    if (status === "completed" || status === "cancelled" || status === "stopped" || status === "draft") {
-      return false;
-    }
-    const endDate = medicationRequest.dispenseRequest?.validityPeriod?.end;
-    if (!endDate) {
-      return true;
-    }
-    const parsedEndDate = this.parseDate(endDate);
-    if (!parsedEndDate) {
-      return true;
-    }
-    return parsedEndDate.getTime() > Date.now();
-  }
-  /**
-   * Determine if a MedicationStatement is active
-   * @param medicationStatement - The MedicationStatement resource
-   * @returns boolean indicating if the medication statement is active
-   */
-  static isActiveMedicationStatement(medicationStatement) {
-    const status = medicationStatement.status?.toLowerCase();
-    if (status === "active" || status === "intended" || status === "unknown") {
-      return true;
-    }
-    if (status === "completed" || status === "stopped" || status === "not-taken") {
-      return false;
-    }
-    let endDate;
-    if (medicationStatement.effectivePeriod?.end) {
-      endDate = medicationStatement.effectivePeriod.end;
-    }
-    if (!endDate) {
-      return true;
-    }
-    const parsedEndDate = this.parseDate(endDate);
-    if (!parsedEndDate) {
-      return true;
-    }
-    return parsedEndDate.getTime() > Date.now();
-  }
   /**
    * Internal static implementation that actually generates the narrative
    * @param resources - FHIR Medication resources
@@ -1474,20 +1571,11 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
     const medicationRequests = this.getMedicationRequests(templateUtilities, resources);
     const medicationStatements = this.getMedicationStatements(templateUtilities, resources);
     const allActiveMedications = [];
-    const allInactiveMedications = [];
     medicationRequests.forEach((mr) => {
-      if (this.isActiveMedicationRequest(mr.resource)) {
-        allActiveMedications.push({ type: "request", resource: mr.resource, extension: mr.extension });
-      } else {
-        allInactiveMedications.push({ type: "request", resource: mr.resource, extension: mr.extension });
-      }
+      allActiveMedications.push({ type: "request", resource: mr.resource, extension: mr.extension });
     });
     medicationStatements.forEach((ms) => {
-      if (this.isActiveMedicationStatement(ms.resource)) {
-        allActiveMedications.push({ type: "statement", resource: ms.resource, extension: ms.extension });
-      } else {
-        allInactiveMedications.push({ type: "statement", resource: ms.resource, extension: ms.extension });
-      }
+      allActiveMedications.push({ type: "statement", resource: ms.resource, extension: ms.extension });
     });
     const sortMedications = (medications) => {
       medications.sort((a, b) => {
@@ -1517,11 +1605,7 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
     };
     if (allActiveMedications.length > 0) {
       sortMedications(allActiveMedications);
-      html += this.renderCombinedMedications(templateUtilities, allActiveMedications, true);
-    }
-    if (allInactiveMedications.length > 0) {
-      sortMedications(allInactiveMedications);
-      html += this.renderCombinedMedications(templateUtilities, allInactiveMedications, false);
+      html += this.renderCombinedMedications(templateUtilities, allActiveMedications);
     }
     return html;
   }
@@ -1559,12 +1643,10 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
    * Render HTML table for combined MedicationRequest and MedicationStatement resources
    * @param templateUtilities - Instance of TemplateUtilities for utility functions
    * @param medications - Array of combined medication resources
-   * @param sectionTitle - Title for the section
    * @returns HTML string for rendering
    */
-  static renderCombinedMedications(templateUtilities, medications, isActiveSection) {
+  static renderCombinedMedications(templateUtilities, medications) {
     let html = `
-    <h3>${isActiveSection ? "Active Medications" : "Inactive Medications"}</h3>
       <table>
         <thead>
           <tr>
@@ -1573,9 +1655,7 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
             <th>Sig</th>
             <th>Dispense Quantity</th>
             <th>Refills</th>
-            <th>Start Date</th>${isActiveSection ? "" : `
-            <th>End Date</th>`}
-            <th>Status</th>
+            <th>Start Date</th>
           </tr>
         </thead>
         <tbody>`;
@@ -1587,12 +1667,9 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
       let dispenseQuantity = "-";
       let refills = "-";
       let startDate = "-";
-      let endDate = "-";
-      let status;
       if (medication.type === "request") {
         const mr = medication.resource;
         type = "Request";
-        status = mr.status ? String(mr.status) : "-";
         medicationName = templateUtilities.getMedicationName(
           mr.medicationReference || mr.medicationCodeableConcept
         );
@@ -1606,14 +1683,12 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
         refills = mr.dispenseRequest?.numberOfRepeatsAllowed?.toString() || "-";
         if (mr.dispenseRequest?.validityPeriod) {
           startDate = mr.dispenseRequest.validityPeriod.start || "-";
-          endDate = mr.dispenseRequest.validityPeriod.end || "-";
         } else {
           startDate = mr.authoredOn || "-";
         }
       } else {
         const ms = medication.resource;
         type = "Statement";
-        status = ms.status ? String(ms.status) : "-";
         medicationName = templateUtilities.getMedicationName(
           ms.medicationReference || ms.medicationCodeableConcept
         );
@@ -1622,7 +1697,6 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
           startDate = ms.effectiveDateTime;
         } else if (ms.effectivePeriod) {
           startDate = ms.effectivePeriod.start || "-";
-          endDate = ms.effectivePeriod.end || "-";
         }
       }
       html += `
@@ -1632,9 +1706,7 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
           <td>${sig}</td>
           <td>${dispenseQuantity}</td>
           <td>${refills}</td>
-          <td>${startDate}</td>${isActiveSection ? "" : `
-          <td>${endDate}</td>`}
-          <td>${status}</td>
+          <td>${startDate}</td>
         </tr>`;
     }
     html += `
@@ -1775,6 +1847,7 @@ var ProblemListTemplate = class _ProblemListTemplate {
    * @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(resources, timezone) {
     const templateUtilities = new TemplateUtilities(resources);
     let html = ``;
@@ -1791,7 +1864,6 @@ var ProblemListTemplate = class _ProblemListTemplate {
               <th>Problem</th>
               <th>Onset Date</th>
               <th>Recorded Date</th>
-              <th>Notes</th>
             </tr>
           </thead>
           <tbody>`;
@@ -1800,7 +1872,6 @@ var ProblemListTemplate = class _ProblemListTemplate {
           <td class="Name">${templateUtilities.codeableConcept(cond.code)}</td>
           <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
           <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
-          <td class="Notes">${templateUtilities.renderNotes(cond.note, timezone)}</td>
         </tr>`;
     }
     html += `</tbody>
@@ -1809,13 +1880,6 @@ 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 {
   /**
@@ -1998,6 +2062,400 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
   generateNarrative(resources, timezone) {
     return _DiagnosticResultsTemplate.generateStaticNarrative(resources, timezone);
   }
+  /**
+   * Helper function to format observation data fields
+   * @param obsData - Record containing observation data fields
+   */
+  formatSummaryObservationData(obsData) {
+    const valueType = obsData["valueType"];
+    switch (valueType) {
+      case "valueQuantity":
+        if (obsData["value"] && obsData["unit"]) {
+          obsData["formattedValue"] = `${obsData["value"]} ${obsData["unit"]}`;
+        } else if (obsData["value"]) {
+          obsData["formattedValue"] = obsData["value"];
+        }
+        break;
+      case "valueCodeableConcept":
+      case "valueString":
+      case "valueBoolean":
+      case "valueInteger":
+      case "valueDateTime":
+      case "valueTime":
+        obsData["formattedValue"] = obsData["value"] ?? "";
+        break;
+      case "valuePeriod":
+        if (obsData["valuePeriodStart"] && obsData["valuePeriodEnd"]) {
+          obsData["formattedValue"] = `${obsData["valuePeriodStart"]} - ${obsData["valuePeriodEnd"]}`;
+        } else if (obsData["valuePeriodStart"]) {
+          obsData["formattedValue"] = `From ${obsData["valuePeriodStart"]}`;
+        } else if (obsData["valuePeriodEnd"]) {
+          obsData["formattedValue"] = `Until ${obsData["valuePeriodEnd"]}`;
+        }
+        break;
+      case "valueSampledData": {
+        const sampledParts = [];
+        if (obsData["sampledDataOriginValue"]) {
+          sampledParts.push(`Origin: ${obsData["sampledDataOriginValue"]}${obsData["sampledDataOriginUnit"] ? " " + obsData["sampledDataOriginUnit"] : ""}`);
+        }
+        if (obsData["sampledDataPeriod"]) {
+          sampledParts.push(`Period: ${obsData["sampledDataPeriod"]}`);
+        }
+        if (obsData["sampledDataFactor"]) {
+          sampledParts.push(`Factor: ${obsData["sampledDataFactor"]}`);
+        }
+        if (obsData["sampledDataLowerLimit"]) {
+          sampledParts.push(`Lower: ${obsData["sampledDataLowerLimit"]}`);
+        }
+        if (obsData["sampledDataUpperLimit"]) {
+          sampledParts.push(`Upper: ${obsData["sampledDataUpperLimit"]}`);
+        }
+        if (obsData["sampledDataData"]) {
+          sampledParts.push(`Data: ${obsData["sampledDataData"]}`);
+        }
+        obsData["formattedValue"] = sampledParts.join(", ");
+        break;
+      }
+      case "valueRange": {
+        const rangeParts = [];
+        if (obsData["valueRangeLowValue"]) {
+          rangeParts.push(`${obsData["valueRangeLowValue"]}${obsData["valueRangeLowUnit"] ? " " + obsData["valueRangeLowUnit"] : ""}`);
+        }
+        if (obsData["valueRangeHighValue"]) {
+          rangeParts.push(`${obsData["valueRangeHighValue"]}${obsData["valueRangeHighUnit"] ? " " + obsData["valueRangeHighUnit"] : ""}`);
+        }
+        obsData["formattedValue"] = rangeParts.join(" - ");
+        break;
+      }
+      case "valueRatio": {
+        const numerator = obsData["valueRatioNumeratorValue"] ? `${obsData["valueRatioNumeratorValue"]}${obsData["valueRatioNumeratorUnit"] ? " " + obsData["valueRatioNumeratorUnit"] : ""}` : "";
+        const denominator = obsData["valueRatioDenominatorValue"] ? `${obsData["valueRatioDenominatorValue"]}${obsData["valueRatioDenominatorUnit"] ? " " + obsData["valueRatioDenominatorUnit"] : ""}` : "";
+        if (numerator && denominator) {
+          obsData["formattedValue"] = `${numerator} / ${denominator}`;
+        } else if (numerator) {
+          obsData["formattedValue"] = numerator;
+        }
+        break;
+      }
+      default:
+        obsData["formattedValue"] = obsData["value"] ?? "";
+        break;
+    }
+    if (obsData["referenceRangeLow"]) {
+      obsData["referenceRange"] = obsData["referenceRangeLow"] + " " + obsData["referenceRangeLowUnit"];
+    }
+    if (obsData["referenceRangeHigh"]) {
+      if (obsData["referenceRange"]) {
+        obsData["referenceRange"] += " - ";
+      } else {
+        obsData["referenceRange"] = "";
+      }
+      obsData["referenceRange"] += obsData["referenceRangeHigh"] + " " + obsData["referenceRangeHighUnit"];
+    }
+    if (obsData["referenceRangeAgeLowValue"] || obsData["referenceRangeAgeHighValue"]) {
+      const ageParts = [];
+      if (obsData["referenceRangeAgeLowValue"]) {
+        ageParts.push(`${obsData["referenceRangeAgeLowValue"]}${obsData["referenceRangeAgeLowUnit"] ? " " + obsData["referenceRangeAgeLowUnit"] : ""}`);
+      }
+      if (obsData["referenceRangeAgeHighValue"]) {
+        ageParts.push(`${obsData["referenceRangeAgeHighValue"]}${obsData["referenceRangeAgeHighUnit"] ? " " + obsData["referenceRangeAgeHighUnit"] : ""}`);
+      }
+      if (obsData["referenceRange"]) {
+        obsData["referenceRange"] += ` (Age: ${ageParts.join(" - ")})`;
+      } else {
+        obsData["referenceRange"] = `Age: ${ageParts.join(" - ")}`;
+      }
+    }
+  }
+  /**
+   * Helper function to extract observation field data
+   * @param column - Column data from the summary
+   * @param targetData - Record to populate with extracted data
+   */
+  extractSummaryObservationFields(column, targetData) {
+    switch (column.title) {
+      case "Labs Name":
+        targetData["code"] = column.text?.div ?? "";
+        break;
+      case "effectiveDateTime":
+        targetData["effectiveDateTime"] = column.text?.div ?? "";
+        break;
+      case "effectivePeriod.start":
+        targetData["effectivePeriodStart"] = column.text?.div ?? "";
+        break;
+      case "effectivePeriod.end":
+        targetData["effectivePeriodEnd"] = column.text?.div ?? "";
+        break;
+      // valueQuantity
+      case "valueQuantity.value":
+        targetData["value"] = column.text?.div ?? "";
+        targetData["valueType"] = "valueQuantity";
+        break;
+      case "valueQuantity.unit":
+        targetData["unit"] = column.text?.div ?? "";
+        break;
+      // valueCodeableConcept
+      case "valueCodeableConcept.text":
+        targetData["value"] = column.text?.div ?? "";
+        targetData["valueType"] = "valueCodeableConcept";
+        break;
+      case "valueCodeableConcept.coding.display":
+        if (!targetData["value"]) {
+          targetData["value"] = column.text?.div ?? "";
+          targetData["valueType"] = "valueCodeableConcept";
+        }
+        break;
+      // valueString
+      case "valueString":
+        targetData["value"] = column.text?.div ?? "";
+        targetData["valueType"] = "valueString";
+        break;
+      // valueBoolean
+      case "valueBoolean":
+        targetData["value"] = column.text?.div ?? "";
+        targetData["valueType"] = "valueBoolean";
+        break;
+      // valueInteger
+      case "valueInteger":
+        targetData["value"] = column.text?.div ?? "";
+        targetData["valueType"] = "valueInteger";
+        break;
+      // valueDateTime
+      case "valueDateTime":
+        targetData["value"] = column.text?.div ?? "";
+        targetData["valueType"] = "valueDateTime";
+        break;
+      // valuePeriod
+      case "valuePeriod.start":
+        targetData["valuePeriodStart"] = column.text?.div ?? "";
+        targetData["valueType"] = "valuePeriod";
+        break;
+      case "valuePeriod.end":
+        targetData["valuePeriodEnd"] = column.text?.div ?? "";
+        targetData["valueType"] = "valuePeriod";
+        break;
+      // valueTime
+      case "valueTime":
+        targetData["value"] = column.text?.div ?? "";
+        targetData["valueType"] = "valueTime";
+        break;
+      // valueSampledData
+      case "valueSampledData.origin.value":
+        targetData["sampledDataOriginValue"] = column.text?.div ?? "";
+        targetData["valueType"] = "valueSampledData";
+        break;
+      case "valueSampledData.origin.unit":
+        targetData["sampledDataOriginUnit"] = column.text?.div ?? "";
+        break;
+      case "valueSampledData.period":
+        targetData["sampledDataPeriod"] = column.text?.div ?? "";
+        break;
+      case "valueSampledData.factor":
+        targetData["sampledDataFactor"] = column.text?.div ?? "";
+        break;
+      case "valueSampledData.lowerLimit":
+        targetData["sampledDataLowerLimit"] = column.text?.div ?? "";
+        break;
+      case "valueSampledData.upperLimit":
+        targetData["sampledDataUpperLimit"] = column.text?.div ?? "";
+        break;
+      case "valueSampledData.data":
+        targetData["sampledDataData"] = column.text?.div ?? "";
+        break;
+      // valueRange
+      case "valueRange.low.value":
+        targetData["valueRangeLowValue"] = column.text?.div ?? "";
+        targetData["valueType"] = "valueRange";
+        break;
+      case "valueRange.low.unit":
+        targetData["valueRangeLowUnit"] = column.text?.div ?? "";
+        break;
+      case "valueRange.high.value":
+        targetData["valueRangeHighValue"] = column.text?.div ?? "";
+        break;
+      case "valueRange.high.unit":
+        targetData["valueRangeHighUnit"] = column.text?.div ?? "";
+        break;
+      // valueRatio
+      case "valueRatio.numerator.value":
+        targetData["valueRatioNumeratorValue"] = column.text?.div ?? "";
+        targetData["valueType"] = "valueRatio";
+        break;
+      case "valueRatio.numerator.unit":
+        targetData["valueRatioNumeratorUnit"] = column.text?.div ?? "";
+        break;
+      case "valueRatio.denominator.value":
+        targetData["valueRatioDenominatorValue"] = column.text?.div ?? "";
+        break;
+      case "valueRatio.denominator.unit":
+        targetData["valueRatioDenominatorUnit"] = column.text?.div ?? "";
+        break;
+      // referenceRange
+      case "referenceRange.low.value":
+        targetData["referenceRangeLow"] = column.text?.div ?? "";
+        break;
+      case "referenceRange.low.unit":
+        targetData["referenceRangeLowUnit"] = column.text?.div ?? "";
+        break;
+      case "referenceRange.high.value":
+        targetData["referenceRangeHigh"] = column.text?.div ?? "";
+        break;
+      case "referenceRange.high.unit":
+        targetData["referenceRangeHighUnit"] = column.text?.div ?? "";
+        break;
+      case "referenceRange.age.low.value":
+        targetData["referenceRangeAgeLowValue"] = column.text?.div ?? "";
+        break;
+      case "referenceRange.age.low.unit":
+        targetData["referenceRangeAgeLowUnit"] = column.text?.div ?? "";
+        break;
+      case "referenceRange.age.high.value":
+        targetData["referenceRangeAgeHighValue"] = column.text?.div ?? "";
+        break;
+      case "referenceRange.age.high.unit":
+        targetData["referenceRangeAgeHighUnit"] = column.text?.div ?? "";
+        break;
+      default:
+        break;
+    }
+  }
+  /**
+   * Generate HTML narrative for Diagnostic Results & Observation 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>`;
+    let observationhtml = `
+      <div>
+        <h3>Observations</h3>
+        <table>
+          <thead>
+            <tr>
+              <th>Code</th>
+              <th>Result</th>
+              <th>Reference Range</th>
+              <th>Date</th>
+            </tr>
+          </thead>
+          <tbody>`;
+    let diagnosticReporthtml = `
+      <div>
+        <h3>Diagnostic Reports</h3>
+        <table>
+          <thead>
+            <tr>
+              <th>Report</th>
+              <th>Performer</th>
+              <th>Issued</th>
+            </tr>
+          </thead>
+          <tbody>`;
+    let observationExists = false;
+    let diagnosticReportExists = false;
+    for (const resourceItem of resources) {
+      for (const rowData of resourceItem.section ?? []) {
+        const data = {};
+        const components = [];
+        for (const columnData of rowData.section ?? []) {
+          if (resourceItem.title === "Observation|Labs Summary Grouped by Lab Code") {
+            if (columnData.text?.div === "Observation.component" && columnData.section) {
+              for (const componentSection of columnData.section) {
+                const componentData = {};
+                for (const nestedColumn of componentSection.section ?? []) {
+                  this.extractSummaryObservationFields(nestedColumn, componentData);
+                }
+                if (Object.keys(componentData).length > 0) {
+                  components.push(componentData);
+                }
+              }
+            } else {
+              this.extractSummaryObservationFields(columnData, data);
+            }
+          } else if (resourceItem.title === "DiagnosticReportLab Summary Grouped by DiagnosticReport|Lab Code") {
+            switch (columnData.title) {
+              case "Diagnostic Report Name":
+                data["report"] = columnData.text?.div ?? "";
+                break;
+              case "Performer":
+                data["performer"] = columnData.text?.div ?? "";
+                break;
+              case "Issued Date":
+                data["issued"] = columnData.text?.div ?? "";
+                break;
+              case "Status":
+                data["status"] = columnData.text?.div ?? "";
+                break;
+              default:
+                break;
+            }
+          }
+        }
+        if (resourceItem.title === "Observation|Labs Summary Grouped by Lab Code") {
+          observationExists = true;
+          let date = data["effectiveDateTime"] ? templateUtilities.renderTime(data["effectiveDateTime"], timezone) : "";
+          if (!date && data["effectivePeriodStart"]) {
+            date = templateUtilities.renderTime(data["effectivePeriodStart"], timezone);
+            if (data["effectivePeriodEnd"]) {
+              date += " - " + templateUtilities.renderTime(data["effectivePeriodEnd"], timezone);
+            }
+          }
+          if (components.length > 0) {
+            const groupName = data["code"] ?? "";
+            for (const component of components) {
+              this.formatSummaryObservationData(component);
+              observationhtml += `
+                <tr>
+                  <td>${groupName ? groupName + " - " : ""}${component["code"] ?? "-"}</td>
+                  <td>${component["formattedValue"] ?? "-"}</td>
+                  <td>${component["referenceRange"]?.trim() ?? "-"}</td>
+                  <td>${date ?? "-"}</td>
+                </tr>`;
+            }
+          } else {
+            this.formatSummaryObservationData(data);
+            observationhtml += `
+                <tr>
+                  <td>${data["code"] ?? "-"}</td>
+                  <td>${data["formattedValue"] ?? "-"}</td>
+                  <td>${data["referenceRange"]?.trim() ?? "-"}</td>
+                  <td>${date ?? "-"}</td>
+                </tr>`;
+          }
+        } else if (resourceItem.title === "DiagnosticReportLab Summary Grouped by DiagnosticReport|Lab Code") {
+          if (data["status"] === "final") {
+            diagnosticReportExists = true;
+            diagnosticReporthtml += `
+                  <tr>
+                    <td>${data["report"] ?? "-"}</td>
+                    <td>${data["performer"] ?? "-"}</td>
+                    <td>${templateUtilities.renderTime(data["issued"], timezone) ?? "-"}</td>
+                  </tr>`;
+          }
+        }
+      }
+    }
+    if (observationExists) {
+      html += observationhtml;
+      html += `
+            </tbody>
+          </table>
+          </div>`;
+    }
+    if (diagnosticReportExists) {
+      html += diagnosticReporthtml;
+      html += `
+            </tbody>
+          </table>
+          </div>`;
+    }
+    html += `
+      </div>`;
+    return html;
+  }
   /**
    * Internal static implementation that actually generates the narrative
    * @param resources - FHIR resources array containing Observation and DiagnosticReport resources
@@ -2139,6 +2597,57 @@ var HistoryOfProceduresTemplate = class _HistoryOfProceduresTemplate {
     });
     return _HistoryOfProceduresTemplate.generateStaticNarrative(resources, timezone);
   }
+  /**
+   * Generate HTML narrative for Procedure 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>Procedure</th>
+              <th>Performer</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 ?? []) {
+          switch (columnData.title) {
+            case "Procedure Name":
+              data["procedure"] = columnData.text?.div ?? "";
+              break;
+            case "Performer":
+              data["performer"] = columnData.text?.div ?? "";
+              break;
+            case "Performed Date":
+              data["date"] = columnData.text?.div ?? "";
+              break;
+            default:
+              break;
+          }
+        }
+        html += `
+            <tr>
+              <td>${data["procedure"] ?? "-"}</td>
+              <td>${data["performer"] ?? "-"}</td>
+              <td>${templateUtilities.renderTime(data["date"], timezone) ?? "-"}</td>
+            </tr>`;
+      }
+    }
+    html += `
+          </tbody>
+        </table>
+      </div>`;
+    return html;
+  }
   /**
    * Internal static implementation that actually generates the narrative
    * @param resources - FHIR Procedure resources
@@ -2235,6 +2744,7 @@ var PastHistoryOfIllnessTemplate = class {
    * @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
   generateNarrative(resources, timezone) {
     const templateUtilities = new TemplateUtilities(resources);
     let html = ``;
@@ -2252,7 +2762,6 @@ var PastHistoryOfIllnessTemplate = class {
               <th>Onset Date</th>
               <th>Recorded Date</th>
               <th>Resolved Date</th>
-              <th>Notes</th>
             </tr>
           </thead>
           <tbody>`;
@@ -2262,7 +2771,6 @@ var PastHistoryOfIllnessTemplate = class {
           <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
           <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
           <td class="ResolvedDate">${templateUtilities.renderDate(cond.abatementDateTime)}</td>
-          <td class="Notes">${templateUtilities.renderNotes(cond.note, timezone)}</td>
         </tr>`;
     }
     html += `</tbody>
@@ -2415,7 +2923,6 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
               <th>Problem</th>
               <th>Onset Date</th>
               <th>Recorded Date</th>
-              <th>Notes</th>
             </tr>
           </thead>
           <tbody>`;
@@ -2424,7 +2931,6 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
           <td class="Name">${templateUtilities.codeableConcept(cond.code)}</td>
           <td class="OnsetDate">${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>
         </tr>`;
       }
       html += `</tbody>
@@ -2440,7 +2946,6 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
             <th>Description</th>
             <th>Summary</th>
             <th>Findings</th>
-            <th>Notes</th>
           </tr>
         </thead>
         <tbody>`;
@@ -2469,7 +2974,6 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
           }
           findingsHtml += "</ul>";
         }
-        const notes = templateUtilities.renderNotes(impression.note, timezone);
         html += `
           <tr id="${templateUtilities.narrativeLinkId(impression)}">
             <td>${formattedDate}</td>
@@ -2477,7 +2981,6 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
             <td>${impression.description || ""}</td>
             <td>${impression.summary || ""}</td>
             <td>${findingsHtml}</td>
-            <td>${notes}</td>
           </tr>`;
       }
       html += `</tbody>