@imranq2/fhirpatientsummary 1.0.24 → 1.0.26

package/dist/index.cjs

@@ -142,7 +142,7 @@ var IPSSectionResourceFilters = {
   // Only include pregnancy history Observations
   ["HistoryOfPregnancySection" /* PREGNANCY_HISTORY */]: (resource) => resource.resourceType === "Observation" && (resource.code?.coding?.some((c) => Object.keys(PREGNANCY_LOINC_CODES.PREGNANCY_STATUS).includes(c.code)) || resource.valueCodeableConcept?.coding?.some((c) => Object.keys(PREGNANCY_LOINC_CODES.PREGNANCY_OUTCOME).includes(c.code))),
   // Only include Conditions or completed ClinicalImpressions
-  ["FunctionalStatusSection" /* FUNCTIONAL_STATUS */]: (resource) => resource.resourceType === "Condition" || resource.resourceType === "ClinicalImpression" && resource.status === "completed",
+  ["FunctionalStatusSection" /* FUNCTIONAL_STATUS */]: (resource) => resource.resourceType === "Condition" && resource.clinicalStatus?.coding?.some((c) => !["inactive", "resolved"].includes(c.code)) || resource.resourceType === "ClinicalImpression" && resource.status === "completed",
   // Only include resolved medical history Conditions
   ["HistoryOfPastIllnessSection" /* MEDICAL_HISTORY */]: (resource) => resource.resourceType === "Condition" && resource.clinicalStatus?.coding?.some((c) => ["inactive", "resolved"].includes(c.code)),
   // Only include active care plans
@@ -1326,6 +1326,7 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
    */
   generateSummaryNarrative(resources, timezone) {
     const templateUtilities = new TemplateUtilities(resources);
+    let isSummaryCreated = false;
     let html = `
       <div>
         <table>
@@ -1355,6 +1356,7 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
               break;
           }
         }
+        isSummaryCreated = true;
         html += `
             <tr>
               <td>${data["allergen"] ?? "-"}</td>
@@ -1367,7 +1369,7 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
           </tbody>
         </table>
       </div>`;
-    return html;
+    return isSummaryCreated ? html : void 0;
   }
   /**
    * Internal static implementation that actually generates the narrative
@@ -1513,6 +1515,7 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
    */
   generateSummaryNarrative(resources, timezone) {
     const templateUtilities = new TemplateUtilities(resources);
+    let isSummaryCreated = false;
     let html = `
         <div>
             <table>
@@ -1557,6 +1560,7 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
           }
         }
         if (data["status"] === "active") {
+          isSummaryCreated = true;
           html += `
                     <tr>
                         <td>${data["medication"]}</td>
@@ -1572,7 +1576,7 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
             </tbody>
             </table>
         </div>`;
-    return html;
+    return isSummaryCreated ? html : void 0;
   }
   /**
    * Safely parse a date string and return a valid Date object or null
@@ -1768,6 +1772,7 @@ var ImmunizationsTemplate = class _ImmunizationsTemplate {
    */
   generateSummaryNarrative(resources, timezone) {
     const templateUtilities = new TemplateUtilities(resources);
+    let isSummaryCreated = false;
     let html = `
       <div>
         <table>
@@ -1798,6 +1803,7 @@ var ImmunizationsTemplate = class _ImmunizationsTemplate {
           }
         }
         if (data["status"] === "completed") {
+          isSummaryCreated = true;
           html += `
               <tr>
                 <td>${data["immunization"] ?? "-"}</td>
@@ -1811,7 +1817,7 @@ var ImmunizationsTemplate = class _ImmunizationsTemplate {
           </tbody>
         </table>
       </div>`;
-    return html;
+    return isSummaryCreated ? html : void 0;
   }
   /**
    * Internal static implementation that actually generates the narrative
@@ -1881,8 +1887,8 @@ var ProblemListTemplate = class _ProblemListTemplate {
     let html = ``;
     const activeConditions = resources.map((entry) => entry) || [];
     activeConditions.sort((a, b) => {
-      const dateA = a.onsetDateTime ? new Date(a.onsetDateTime).getTime() : 0;
-      const dateB = b.onsetDateTime ? new Date(b.onsetDateTime).getTime() : 0;
+      const dateA = a.recordedDate ? new Date(a.recordedDate).getTime() : 0;
+      const dateB = b.recordedDate ? new Date(b.recordedDate).getTime() : 0;
       return dateB - dateA;
     });
     html += `
@@ -1895,12 +1901,17 @@ var ProblemListTemplate = class _ProblemListTemplate {
             </tr>
           </thead>
           <tbody>`;
+    const addedConditionCodes = /* @__PURE__ */ new Set();
     for (const cond of activeConditions) {
-      html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
-          <td class="Name">${templateUtilities.codeableConcept(cond.code)}</td>
-          <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
-          <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
-        </tr>`;
+      const conditionCode = templateUtilities.codeableConcept(cond.code);
+      if (!addedConditionCodes.has(conditionCode)) {
+        addedConditionCodes.add(conditionCode);
+        html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
+            <td class="Name">${conditionCode}</td>
+            <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
+            <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
+          </tr>`;
+      }
     }
     html += `</tbody>
         </table>`;
@@ -1927,6 +1938,7 @@ var VitalSignsTemplate = class _VitalSignsTemplate {
    */
   generateSummaryNarrative(resources, timezone) {
     const templateUtilities = new TemplateUtilities(resources);
+    let isSummaryCreated = false;
     let html = `
       <div>
         <table>
@@ -1966,6 +1978,7 @@ var VitalSignsTemplate = class _VitalSignsTemplate {
             data[columnTitle] = columnData.text?.div ?? "";
           }
         }
+        isSummaryCreated = true;
         html += `
           <tr>
             <td>${data["Vital Name"] ?? "-"}</td>
@@ -1979,7 +1992,7 @@ var VitalSignsTemplate = class _VitalSignsTemplate {
           </tbody>
         </table>
       </div>`;
-    return html;
+    return isSummaryCreated ? html : void 0;
   }
   /**
    * Internal static implementation that actually generates the narrative
@@ -2382,8 +2395,8 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
             </tr>
           </thead>
           <tbody>`;
-    let observationExists = false;
-    let diagnosticReportExists = false;
+    const observationAdded = /* @__PURE__ */ new Set();
+    const diagnosticReportAdded = /* @__PURE__ */ new Set();
     for (const resourceItem of resources) {
       for (const rowData of resourceItem.section ?? []) {
         const data = {};
@@ -2423,7 +2436,6 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
           }
         }
         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);
@@ -2432,48 +2444,59 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
             }
           }
           if (components.length > 0) {
-            const groupName = data["code"] ?? "";
+            const groupName = data["code"] ? `${data["code"]} - ` : "";
             for (const component of components) {
-              this.formatSummaryObservationData(component);
-              observationhtml += `
-                <tr>
-                  <td>${groupName ? groupName + " - " : ""}${component["code"] ?? "-"}</td>
-                  <td>${component["formattedValue"] ?? "-"}</td>
-                  <td>${component["referenceRange"]?.trim() ?? "-"}</td>
-                  <td>${date ?? "-"}</td>
-                </tr>`;
+              const componentCode = `${groupName}${component["code"] ?? ""}`;
+              if (componentCode && !observationAdded.has(componentCode)) {
+                observationAdded.add(componentCode);
+                this.formatSummaryObservationData(component);
+                observationhtml += `
+                  <tr>
+                    <td>${componentCode}</td>
+                    <td>${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>`;
+            const code = data["code"] ?? "";
+            if (code && !observationAdded.has(code)) {
+              observationAdded.add(code);
+              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>${templateUtilities.renderTime(data["issued"], timezone) ?? "-"}</td>
-                  </tr>`;
+            const reportName = data["report"] ?? "";
+            if (reportName && !diagnosticReportAdded.has(reportName)) {
+              diagnosticReportAdded.add(reportName);
+              diagnosticReporthtml += `
+                    <tr>
+                      <td>${data["report"] ?? "-"}</td>
+                      <td>${data["performer"] ?? "-"}</td>
+                      <td>${templateUtilities.renderTime(data["issued"], timezone) ?? "-"}</td>
+                    </tr>`;
+            }
           }
         }
       }
     }
-    if (observationExists) {
+    if (observationAdded.size > 0) {
       html += observationhtml;
       html += `
             </tbody>
           </table>
           </div>`;
     }
-    if (diagnosticReportExists) {
+    if (diagnosticReportAdded.size > 0) {
       html += diagnosticReporthtml;
       html += `
             </tbody>
@@ -2482,7 +2505,7 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
     }
     html += `
       </div>`;
-    return html;
+    return observationAdded.size > 0 || diagnosticReportAdded.size > 0 ? html : void 0;
   }
   /**
    * Internal static implementation that actually generates the narrative
@@ -2496,8 +2519,8 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
     const observations = this.getObservations(resources);
     if (observations.length > 0) {
       observations.sort((a, b) => {
-        const dateA = a.effectiveDateTime || a.effectivePeriod?.start;
-        const dateB = b.effectiveDateTime || b.effectivePeriod?.start;
+        const dateA = a.effectiveDateTime || a.effectivePeriod?.start || a.effectivePeriod?.end;
+        const dateB = b.effectiveDateTime || b.effectivePeriod?.start || b.effectivePeriod?.end;
         return dateA && dateB ? new Date(dateB).getTime() - new Date(dateA).getTime() : 0;
       });
       html += this.renderObservations(templateUtilities, observations, timezone);
@@ -2552,17 +2575,22 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
           </tr>
         </thead>
         <tbody>`;
+    const observationAdded = /* @__PURE__ */ new Set();
     for (const obs of observations) {
-      html += `
-        <tr id="${templateUtilities.narrativeLinkId(obs)}">
-          <td>${templateUtilities.codeableConcept(obs.code)}</td>
-          <td>${templateUtilities.extractObservationValue(obs)}</td>
-          <td>${templateUtilities.extractObservationValueUnit(obs)}</td>
-          <td>${templateUtilities.firstFromCodeableConceptList(obs.interpretation)}</td>
-          <td>${templateUtilities.concatReferenceRange(obs.referenceRange)}</td>
-          <td>${templateUtilities.renderNotes(obs.note, timezone)}</td>
-          <td>${obs.effectiveDateTime ? templateUtilities.renderTime(obs.effectiveDateTime, timezone) : obs.effectivePeriod ? templateUtilities.renderPeriod(obs.effectivePeriod, timezone) : ""}</td>
-        </tr>`;
+      const obsCode = templateUtilities.codeableConcept(obs.code);
+      if (!observationAdded.has(obsCode)) {
+        observationAdded.add(obsCode);
+        html += `
+          <tr id="${templateUtilities.narrativeLinkId(obs)}">
+            <td>${obsCode}</td>
+            <td>${templateUtilities.extractObservationValue(obs)}</td>
+            <td>${templateUtilities.extractObservationValueUnit(obs)}</td>
+            <td>${templateUtilities.firstFromCodeableConceptList(obs.interpretation)}</td>
+            <td>${templateUtilities.concatReferenceRange(obs.referenceRange)}</td>
+            <td>${templateUtilities.renderNotes(obs.note, timezone)}</td>
+            <td>${obs.effectiveDateTime ? templateUtilities.renderTime(obs.effectiveDateTime, timezone) : obs.effectivePeriod ? templateUtilities.renderPeriod(obs.effectivePeriod, timezone) : ""}</td>
+          </tr>`;
+      }
     }
     html += `
         </tbody>
@@ -2589,18 +2617,23 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
           </tr>
         </thead>
         <tbody>`;
+    const diagnosticReportAdded = /* @__PURE__ */ new Set();
     for (const report of reports) {
-      let resultCount = "";
-      if (report.result && Array.isArray(report.result)) {
-        resultCount = `${report.result.length} result${report.result.length !== 1 ? "s" : ""}`;
+      const reportName = templateUtilities.codeableConcept(report.code);
+      if (!diagnosticReportAdded.has(reportName)) {
+        diagnosticReportAdded.add(reportName);
+        let resultCount = "";
+        if (report.result && Array.isArray(report.result)) {
+          resultCount = `${report.result.length} result${report.result.length !== 1 ? "s" : ""}`;
+        }
+        html += `
+          <tr id="${templateUtilities.narrativeLinkId(report)}">
+            <td>${reportName}</td>
+            <td>${templateUtilities.firstFromCodeableConceptList(report.category)}</td>
+            <td>${resultCount}</td>
+            <td>${report.issued ? templateUtilities.renderTime(report.issued, timezone) : ""}</td>
+          </tr>`;
       }
-      html += `
-        <tr id="${templateUtilities.narrativeLinkId(report)}">
-          <td>${templateUtilities.codeableConcept(report.code)}</td>
-          <td>${templateUtilities.firstFromCodeableConceptList(report.category)}</td>
-          <td>${resultCount}</td>
-          <td>${report.issued ? templateUtilities.renderTime(report.issued, timezone) : ""}</td>
-        </tr>`;
     }
     html += `
         </tbody>
@@ -2633,6 +2666,7 @@ var HistoryOfProceduresTemplate = class _HistoryOfProceduresTemplate {
    */
   generateSummaryNarrative(resources, timezone) {
     const templateUtilities = new TemplateUtilities(resources);
+    let isSummaryCreated = false;
     let html = `
       <div>
         <table>
@@ -2662,6 +2696,7 @@ var HistoryOfProceduresTemplate = class _HistoryOfProceduresTemplate {
               break;
           }
         }
+        isSummaryCreated = true;
         html += `
             <tr>
               <td>${data["procedure"] ?? "-"}</td>
@@ -2674,7 +2709,7 @@ var HistoryOfProceduresTemplate = class _HistoryOfProceduresTemplate {
           </tbody>
         </table>
       </div>`;
-    return html;
+    return isSummaryCreated ? html : void 0;
   }
   /**
    * Internal static implementation that actually generates the narrative
@@ -2778,8 +2813,8 @@ var PastHistoryOfIllnessTemplate = class {
     let html = ``;
     const resolvedConditions = resources.map((entry) => entry) || [];
     resolvedConditions.sort((a, b) => {
-      const dateA = a.onsetDateTime ? new Date(a.onsetDateTime).getTime() : 0;
-      const dateB = b.onsetDateTime ? new Date(b.onsetDateTime).getTime() : 0;
+      const dateA = a.recordedDate ? new Date(a.recordedDate).getTime() : 0;
+      const dateB = b.recordedDate ? new Date(b.recordedDate).getTime() : 0;
       return dateB - dateA;
     });
     html += `
@@ -2793,13 +2828,18 @@ var PastHistoryOfIllnessTemplate = class {
             </tr>
           </thead>
           <tbody>`;
+    const addedConditionCodes = /* @__PURE__ */ new Set();
     for (const cond of resolvedConditions) {
-      html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
-          <td class="Name">${templateUtilities.codeableConcept(cond.code)}</td>
-          <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
-          <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
-          <td class="ResolvedDate">${templateUtilities.renderDate(cond.abatementDateTime)}</td>
-        </tr>`;
+      const conditionCode = templateUtilities.codeableConcept(cond.code);
+      if (!addedConditionCodes.has(conditionCode)) {
+        addedConditionCodes.add(conditionCode);
+        html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
+            <td class="Name">${conditionCode}</td>
+            <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
+            <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
+            <td class="ResolvedDate">${templateUtilities.renderDate(cond.abatementDateTime)}</td>
+          </tr>`;
+      }
     }
     html += `</tbody>
         </table>`;
@@ -2858,6 +2898,7 @@ var PlanOfCareTemplate = class {
    */
   generateSummaryNarrative(resources, timezone) {
     const templateUtilities = new TemplateUtilities(resources);
+    let isSummaryCreated = false;
     let html = `
       <div>
         <table>
@@ -2881,6 +2922,7 @@ var PlanOfCareTemplate = class {
         if (data["status"] !== "active") {
           continue;
         }
+        isSummaryCreated = true;
         html += `
             <tr>
               <td>${data["CarePlan Name"] ?? "-"}</td>
@@ -2894,7 +2936,7 @@ var PlanOfCareTemplate = class {
           </tbody>
         </table>
       </div>`;
-    return html;
+    return isSummaryCreated ? html : void 0;
   }
 };
 
@@ -2922,20 +2964,14 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
     const clinicalImpressions = [];
     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);
-        }
+        activeConditions.push(resourceItem);
       } else if (resourceItem.resourceType === "ClinicalImpression") {
         clinicalImpressions.push(resourceItem);
       }
     }
     activeConditions.sort((a, b) => {
-      const dateA = a.onsetDateTime ? new Date(a.onsetDateTime).getTime() : 0;
-      const dateB = b.onsetDateTime ? new Date(b.onsetDateTime).getTime() : 0;
+      const dateA = a.recordedDate ? new Date(a.recordedDate).getTime() : 0;
+      const dateB = b.recordedDate ? new Date(b.recordedDate).getTime() : 0;
       return dateB - dateA;
     });
     clinicalImpressions.sort((a, b) => {
@@ -2954,12 +2990,17 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
             </tr>
           </thead>
           <tbody>`;
+      const addedConditionCodes = /* @__PURE__ */ new Set();
       for (const cond of activeConditions) {
-        html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
-          <td class="Name">${templateUtilities.codeableConcept(cond.code)}</td>
-          <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
-          <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
-        </tr>`;
+        const conditionCode = templateUtilities.codeableConcept(cond.code);
+        if (!addedConditionCodes.has(conditionCode)) {
+          addedConditionCodes.add(conditionCode);
+          html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
+            <td class="Name">${conditionCode}</td>
+            <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
+            <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
+          </tr>`;
+        }
       }
       html += `</tbody>
         </table>`;
@@ -3347,11 +3388,13 @@ var ComprehensiveIPSCompositionBuilder = class {
           timezone,
           true
         );
-      } else if (sectionType in IPSMandatorySections) {
+      }
+      if (!narrative && sectionType in IPSMandatorySections) {
         narrative = await NarrativeGenerator.createNarrativeAsync(
           IPSMissingMandatorySectionContent[sectionType]
         );
-      } else {
+      }
+      if (!narrative) {
         return this;
       }
       this.addSectionAsync(narrative, sectionType, validResources);
@@ -3369,13 +3412,21 @@ var ComprehensiveIPSCompositionBuilder = class {
         }
       });
     }
-    const narrative = await NarrativeGenerator.generateNarrativeAsync(
+    let narrative = await NarrativeGenerator.generateNarrativeAsync(
       sectionType,
       summaryCompositions,
       timezone,
       true,
       true
     );
+    if (!narrative && sectionType in IPSMandatorySections) {
+      narrative = await NarrativeGenerator.createNarrativeAsync(
+        IPSMissingMandatorySectionContent[sectionType]
+      );
+    }
+    if (!narrative) {
+      return this;
+    }
     this.addSectionAsync(narrative, sectionType, sectionResources);
     return this;
   }

package/dist/index.js

@@ -114,7 +114,7 @@ var IPSSectionResourceFilters = {
   // Only include pregnancy history Observations
   ["HistoryOfPregnancySection" /* PREGNANCY_HISTORY */]: (resource) => resource.resourceType === "Observation" && (resource.code?.coding?.some((c) => Object.keys(PREGNANCY_LOINC_CODES.PREGNANCY_STATUS).includes(c.code)) || resource.valueCodeableConcept?.coding?.some((c) => Object.keys(PREGNANCY_LOINC_CODES.PREGNANCY_OUTCOME).includes(c.code))),
   // Only include Conditions or completed ClinicalImpressions
-  ["FunctionalStatusSection" /* FUNCTIONAL_STATUS */]: (resource) => resource.resourceType === "Condition" || resource.resourceType === "ClinicalImpression" && resource.status === "completed",
+  ["FunctionalStatusSection" /* FUNCTIONAL_STATUS */]: (resource) => resource.resourceType === "Condition" && resource.clinicalStatus?.coding?.some((c) => !["inactive", "resolved"].includes(c.code)) || resource.resourceType === "ClinicalImpression" && resource.status === "completed",
   // Only include resolved medical history Conditions
   ["HistoryOfPastIllnessSection" /* MEDICAL_HISTORY */]: (resource) => resource.resourceType === "Condition" && resource.clinicalStatus?.coding?.some((c) => ["inactive", "resolved"].includes(c.code)),
   // Only include active care plans
@@ -1298,6 +1298,7 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
    */
   generateSummaryNarrative(resources, timezone) {
     const templateUtilities = new TemplateUtilities(resources);
+    let isSummaryCreated = false;
     let html = `
       <div>
         <table>
@@ -1327,6 +1328,7 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
               break;
           }
         }
+        isSummaryCreated = true;
         html += `
             <tr>
               <td>${data["allergen"] ?? "-"}</td>
@@ -1339,7 +1341,7 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
           </tbody>
         </table>
       </div>`;
-    return html;
+    return isSummaryCreated ? html : void 0;
   }
   /**
    * Internal static implementation that actually generates the narrative
@@ -1485,6 +1487,7 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
    */
   generateSummaryNarrative(resources, timezone) {
     const templateUtilities = new TemplateUtilities(resources);
+    let isSummaryCreated = false;
     let html = `
         <div>
             <table>
@@ -1529,6 +1532,7 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
           }
         }
         if (data["status"] === "active") {
+          isSummaryCreated = true;
           html += `
                     <tr>
                         <td>${data["medication"]}</td>
@@ -1544,7 +1548,7 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
             </tbody>
             </table>
         </div>`;
-    return html;
+    return isSummaryCreated ? html : void 0;
   }
   /**
    * Safely parse a date string and return a valid Date object or null
@@ -1740,6 +1744,7 @@ var ImmunizationsTemplate = class _ImmunizationsTemplate {
    */
   generateSummaryNarrative(resources, timezone) {
     const templateUtilities = new TemplateUtilities(resources);
+    let isSummaryCreated = false;
     let html = `
       <div>
         <table>
@@ -1770,6 +1775,7 @@ var ImmunizationsTemplate = class _ImmunizationsTemplate {
           }
         }
         if (data["status"] === "completed") {
+          isSummaryCreated = true;
           html += `
               <tr>
                 <td>${data["immunization"] ?? "-"}</td>
@@ -1783,7 +1789,7 @@ var ImmunizationsTemplate = class _ImmunizationsTemplate {
           </tbody>
         </table>
       </div>`;
-    return html;
+    return isSummaryCreated ? html : void 0;
   }
   /**
    * Internal static implementation that actually generates the narrative
@@ -1853,8 +1859,8 @@ var ProblemListTemplate = class _ProblemListTemplate {
     let html = ``;
     const activeConditions = resources.map((entry) => entry) || [];
     activeConditions.sort((a, b) => {
-      const dateA = a.onsetDateTime ? new Date(a.onsetDateTime).getTime() : 0;
-      const dateB = b.onsetDateTime ? new Date(b.onsetDateTime).getTime() : 0;
+      const dateA = a.recordedDate ? new Date(a.recordedDate).getTime() : 0;
+      const dateB = b.recordedDate ? new Date(b.recordedDate).getTime() : 0;
       return dateB - dateA;
     });
     html += `
@@ -1867,12 +1873,17 @@ var ProblemListTemplate = class _ProblemListTemplate {
             </tr>
           </thead>
           <tbody>`;
+    const addedConditionCodes = /* @__PURE__ */ new Set();
     for (const cond of activeConditions) {
-      html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
-          <td class="Name">${templateUtilities.codeableConcept(cond.code)}</td>
-          <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
-          <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
-        </tr>`;
+      const conditionCode = templateUtilities.codeableConcept(cond.code);
+      if (!addedConditionCodes.has(conditionCode)) {
+        addedConditionCodes.add(conditionCode);
+        html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
+            <td class="Name">${conditionCode}</td>
+            <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
+            <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
+          </tr>`;
+      }
     }
     html += `</tbody>
         </table>`;
@@ -1899,6 +1910,7 @@ var VitalSignsTemplate = class _VitalSignsTemplate {
    */
   generateSummaryNarrative(resources, timezone) {
     const templateUtilities = new TemplateUtilities(resources);
+    let isSummaryCreated = false;
     let html = `
       <div>
         <table>
@@ -1938,6 +1950,7 @@ var VitalSignsTemplate = class _VitalSignsTemplate {
             data[columnTitle] = columnData.text?.div ?? "";
           }
         }
+        isSummaryCreated = true;
         html += `
           <tr>
             <td>${data["Vital Name"] ?? "-"}</td>
@@ -1951,7 +1964,7 @@ var VitalSignsTemplate = class _VitalSignsTemplate {
           </tbody>
         </table>
       </div>`;
-    return html;
+    return isSummaryCreated ? html : void 0;
   }
   /**
    * Internal static implementation that actually generates the narrative
@@ -2354,8 +2367,8 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
             </tr>
           </thead>
           <tbody>`;
-    let observationExists = false;
-    let diagnosticReportExists = false;
+    const observationAdded = /* @__PURE__ */ new Set();
+    const diagnosticReportAdded = /* @__PURE__ */ new Set();
     for (const resourceItem of resources) {
       for (const rowData of resourceItem.section ?? []) {
         const data = {};
@@ -2395,7 +2408,6 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
           }
         }
         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);
@@ -2404,48 +2416,59 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
             }
           }
           if (components.length > 0) {
-            const groupName = data["code"] ?? "";
+            const groupName = data["code"] ? `${data["code"]} - ` : "";
             for (const component of components) {
-              this.formatSummaryObservationData(component);
-              observationhtml += `
-                <tr>
-                  <td>${groupName ? groupName + " - " : ""}${component["code"] ?? "-"}</td>
-                  <td>${component["formattedValue"] ?? "-"}</td>
-                  <td>${component["referenceRange"]?.trim() ?? "-"}</td>
-                  <td>${date ?? "-"}</td>
-                </tr>`;
+              const componentCode = `${groupName}${component["code"] ?? ""}`;
+              if (componentCode && !observationAdded.has(componentCode)) {
+                observationAdded.add(componentCode);
+                this.formatSummaryObservationData(component);
+                observationhtml += `
+                  <tr>
+                    <td>${componentCode}</td>
+                    <td>${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>`;
+            const code = data["code"] ?? "";
+            if (code && !observationAdded.has(code)) {
+              observationAdded.add(code);
+              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>${templateUtilities.renderTime(data["issued"], timezone) ?? "-"}</td>
-                  </tr>`;
+            const reportName = data["report"] ?? "";
+            if (reportName && !diagnosticReportAdded.has(reportName)) {
+              diagnosticReportAdded.add(reportName);
+              diagnosticReporthtml += `
+                    <tr>
+                      <td>${data["report"] ?? "-"}</td>
+                      <td>${data["performer"] ?? "-"}</td>
+                      <td>${templateUtilities.renderTime(data["issued"], timezone) ?? "-"}</td>
+                    </tr>`;
+            }
           }
         }
       }
     }
-    if (observationExists) {
+    if (observationAdded.size > 0) {
       html += observationhtml;
       html += `
             </tbody>
           </table>
           </div>`;
     }
-    if (diagnosticReportExists) {
+    if (diagnosticReportAdded.size > 0) {
       html += diagnosticReporthtml;
       html += `
             </tbody>
@@ -2454,7 +2477,7 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
     }
     html += `
       </div>`;
-    return html;
+    return observationAdded.size > 0 || diagnosticReportAdded.size > 0 ? html : void 0;
   }
   /**
    * Internal static implementation that actually generates the narrative
@@ -2468,8 +2491,8 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
     const observations = this.getObservations(resources);
     if (observations.length > 0) {
       observations.sort((a, b) => {
-        const dateA = a.effectiveDateTime || a.effectivePeriod?.start;
-        const dateB = b.effectiveDateTime || b.effectivePeriod?.start;
+        const dateA = a.effectiveDateTime || a.effectivePeriod?.start || a.effectivePeriod?.end;
+        const dateB = b.effectiveDateTime || b.effectivePeriod?.start || b.effectivePeriod?.end;
         return dateA && dateB ? new Date(dateB).getTime() - new Date(dateA).getTime() : 0;
       });
       html += this.renderObservations(templateUtilities, observations, timezone);
@@ -2524,17 +2547,22 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
           </tr>
         </thead>
         <tbody>`;
+    const observationAdded = /* @__PURE__ */ new Set();
     for (const obs of observations) {
-      html += `
-        <tr id="${templateUtilities.narrativeLinkId(obs)}">
-          <td>${templateUtilities.codeableConcept(obs.code)}</td>
-          <td>${templateUtilities.extractObservationValue(obs)}</td>
-          <td>${templateUtilities.extractObservationValueUnit(obs)}</td>
-          <td>${templateUtilities.firstFromCodeableConceptList(obs.interpretation)}</td>
-          <td>${templateUtilities.concatReferenceRange(obs.referenceRange)}</td>
-          <td>${templateUtilities.renderNotes(obs.note, timezone)}</td>
-          <td>${obs.effectiveDateTime ? templateUtilities.renderTime(obs.effectiveDateTime, timezone) : obs.effectivePeriod ? templateUtilities.renderPeriod(obs.effectivePeriod, timezone) : ""}</td>
-        </tr>`;
+      const obsCode = templateUtilities.codeableConcept(obs.code);
+      if (!observationAdded.has(obsCode)) {
+        observationAdded.add(obsCode);
+        html += `
+          <tr id="${templateUtilities.narrativeLinkId(obs)}">
+            <td>${obsCode}</td>
+            <td>${templateUtilities.extractObservationValue(obs)}</td>
+            <td>${templateUtilities.extractObservationValueUnit(obs)}</td>
+            <td>${templateUtilities.firstFromCodeableConceptList(obs.interpretation)}</td>
+            <td>${templateUtilities.concatReferenceRange(obs.referenceRange)}</td>
+            <td>${templateUtilities.renderNotes(obs.note, timezone)}</td>
+            <td>${obs.effectiveDateTime ? templateUtilities.renderTime(obs.effectiveDateTime, timezone) : obs.effectivePeriod ? templateUtilities.renderPeriod(obs.effectivePeriod, timezone) : ""}</td>
+          </tr>`;
+      }
     }
     html += `
         </tbody>
@@ -2561,18 +2589,23 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
           </tr>
         </thead>
         <tbody>`;
+    const diagnosticReportAdded = /* @__PURE__ */ new Set();
     for (const report of reports) {
-      let resultCount = "";
-      if (report.result && Array.isArray(report.result)) {
-        resultCount = `${report.result.length} result${report.result.length !== 1 ? "s" : ""}`;
+      const reportName = templateUtilities.codeableConcept(report.code);
+      if (!diagnosticReportAdded.has(reportName)) {
+        diagnosticReportAdded.add(reportName);
+        let resultCount = "";
+        if (report.result && Array.isArray(report.result)) {
+          resultCount = `${report.result.length} result${report.result.length !== 1 ? "s" : ""}`;
+        }
+        html += `
+          <tr id="${templateUtilities.narrativeLinkId(report)}">
+            <td>${reportName}</td>
+            <td>${templateUtilities.firstFromCodeableConceptList(report.category)}</td>
+            <td>${resultCount}</td>
+            <td>${report.issued ? templateUtilities.renderTime(report.issued, timezone) : ""}</td>
+          </tr>`;
       }
-      html += `
-        <tr id="${templateUtilities.narrativeLinkId(report)}">
-          <td>${templateUtilities.codeableConcept(report.code)}</td>
-          <td>${templateUtilities.firstFromCodeableConceptList(report.category)}</td>
-          <td>${resultCount}</td>
-          <td>${report.issued ? templateUtilities.renderTime(report.issued, timezone) : ""}</td>
-        </tr>`;
     }
     html += `
         </tbody>
@@ -2605,6 +2638,7 @@ var HistoryOfProceduresTemplate = class _HistoryOfProceduresTemplate {
    */
   generateSummaryNarrative(resources, timezone) {
     const templateUtilities = new TemplateUtilities(resources);
+    let isSummaryCreated = false;
     let html = `
       <div>
         <table>
@@ -2634,6 +2668,7 @@ var HistoryOfProceduresTemplate = class _HistoryOfProceduresTemplate {
               break;
           }
         }
+        isSummaryCreated = true;
         html += `
             <tr>
               <td>${data["procedure"] ?? "-"}</td>
@@ -2646,7 +2681,7 @@ var HistoryOfProceduresTemplate = class _HistoryOfProceduresTemplate {
           </tbody>
         </table>
       </div>`;
-    return html;
+    return isSummaryCreated ? html : void 0;
   }
   /**
    * Internal static implementation that actually generates the narrative
@@ -2750,8 +2785,8 @@ var PastHistoryOfIllnessTemplate = class {
     let html = ``;
     const resolvedConditions = resources.map((entry) => entry) || [];
     resolvedConditions.sort((a, b) => {
-      const dateA = a.onsetDateTime ? new Date(a.onsetDateTime).getTime() : 0;
-      const dateB = b.onsetDateTime ? new Date(b.onsetDateTime).getTime() : 0;
+      const dateA = a.recordedDate ? new Date(a.recordedDate).getTime() : 0;
+      const dateB = b.recordedDate ? new Date(b.recordedDate).getTime() : 0;
       return dateB - dateA;
     });
     html += `
@@ -2765,13 +2800,18 @@ var PastHistoryOfIllnessTemplate = class {
             </tr>
           </thead>
           <tbody>`;
+    const addedConditionCodes = /* @__PURE__ */ new Set();
     for (const cond of resolvedConditions) {
-      html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
-          <td class="Name">${templateUtilities.codeableConcept(cond.code)}</td>
-          <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
-          <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
-          <td class="ResolvedDate">${templateUtilities.renderDate(cond.abatementDateTime)}</td>
-        </tr>`;
+      const conditionCode = templateUtilities.codeableConcept(cond.code);
+      if (!addedConditionCodes.has(conditionCode)) {
+        addedConditionCodes.add(conditionCode);
+        html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
+            <td class="Name">${conditionCode}</td>
+            <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
+            <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
+            <td class="ResolvedDate">${templateUtilities.renderDate(cond.abatementDateTime)}</td>
+          </tr>`;
+      }
     }
     html += `</tbody>
         </table>`;
@@ -2830,6 +2870,7 @@ var PlanOfCareTemplate = class {
    */
   generateSummaryNarrative(resources, timezone) {
     const templateUtilities = new TemplateUtilities(resources);
+    let isSummaryCreated = false;
     let html = `
       <div>
         <table>
@@ -2853,6 +2894,7 @@ var PlanOfCareTemplate = class {
         if (data["status"] !== "active") {
           continue;
         }
+        isSummaryCreated = true;
         html += `
             <tr>
               <td>${data["CarePlan Name"] ?? "-"}</td>
@@ -2866,7 +2908,7 @@ var PlanOfCareTemplate = class {
           </tbody>
         </table>
       </div>`;
-    return html;
+    return isSummaryCreated ? html : void 0;
   }
 };
 
@@ -2894,20 +2936,14 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
     const clinicalImpressions = [];
     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);
-        }
+        activeConditions.push(resourceItem);
       } else if (resourceItem.resourceType === "ClinicalImpression") {
         clinicalImpressions.push(resourceItem);
       }
     }
     activeConditions.sort((a, b) => {
-      const dateA = a.onsetDateTime ? new Date(a.onsetDateTime).getTime() : 0;
-      const dateB = b.onsetDateTime ? new Date(b.onsetDateTime).getTime() : 0;
+      const dateA = a.recordedDate ? new Date(a.recordedDate).getTime() : 0;
+      const dateB = b.recordedDate ? new Date(b.recordedDate).getTime() : 0;
       return dateB - dateA;
     });
     clinicalImpressions.sort((a, b) => {
@@ -2926,12 +2962,17 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
             </tr>
           </thead>
           <tbody>`;
+      const addedConditionCodes = /* @__PURE__ */ new Set();
       for (const cond of activeConditions) {
-        html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
-          <td class="Name">${templateUtilities.codeableConcept(cond.code)}</td>
-          <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
-          <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
-        </tr>`;
+        const conditionCode = templateUtilities.codeableConcept(cond.code);
+        if (!addedConditionCodes.has(conditionCode)) {
+          addedConditionCodes.add(conditionCode);
+          html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
+            <td class="Name">${conditionCode}</td>
+            <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
+            <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
+          </tr>`;
+        }
       }
       html += `</tbody>
         </table>`;
@@ -3319,11 +3360,13 @@ var ComprehensiveIPSCompositionBuilder = class {
           timezone,
           true
         );
-      } else if (sectionType in IPSMandatorySections) {
+      }
+      if (!narrative && sectionType in IPSMandatorySections) {
         narrative = await NarrativeGenerator.createNarrativeAsync(
           IPSMissingMandatorySectionContent[sectionType]
         );
-      } else {
+      }
+      if (!narrative) {
         return this;
       }
       this.addSectionAsync(narrative, sectionType, validResources);
@@ -3341,13 +3384,21 @@ var ComprehensiveIPSCompositionBuilder = class {
         }
       });
     }
-    const narrative = await NarrativeGenerator.generateNarrativeAsync(
+    let narrative = await NarrativeGenerator.generateNarrativeAsync(
       sectionType,
       summaryCompositions,
       timezone,
       true,
       true
     );
+    if (!narrative && sectionType in IPSMandatorySections) {
+      narrative = await NarrativeGenerator.createNarrativeAsync(
+        IPSMissingMandatorySectionContent[sectionType]
+      );
+    }
+    if (!narrative) {
+      return this;
+    }
     this.addSectionAsync(narrative, sectionType, sectionResources);
     return this;
   }

package/package.json

@@ -1,6 +1,6 @@
 {
   "name": "@imranq2/fhirpatientsummary",
-  "version": "1.0.24",
+  "version": "1.0.26",
   "description": "A template for creating npm packages using TypeScript and VSCode",
   "main": "./dist/index.js",
   "module": "./dist/index.mjs",