@imranq2/fhirpatientsummary 1.0.25 → 1.0.27

package/dist/index.cjs

@@ -115,6 +115,8 @@ var VITAL_SIGNS_SUMMARY_COMPONENT_MAP = {
   "Diastolic Blood Pressure": "valueRatio.denominator.value",
   "Default": "valueString"
 };
+var RESULT_SUMMARY_OBSERVATION_CATEGORIES = ["laboratory", "Lab", "LAB"];
+var RESULT_SUMMARY_OBSERVATION_DATE_FILTER = 2 * 365 * 24 * 60 * 60 * 1e3;
 var IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM = "https://fhir.icanbwell.com/4_0_0/CodeSystem/composition/";
 
 // src/structures/ips_section_resource_map.ts
@@ -134,7 +136,7 @@ var IPSSectionResourceFilters = {
   // 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",
+  ["ResultsSection" /* DIAGNOSTIC_REPORTS */]: (resource) => resource.resourceType === "Observation" && resource.category?.some((cat) => cat.coding?.some((c) => RESULT_SUMMARY_OBSERVATION_CATEGORIES.includes(c.code))),
   // Only include completed procedures
   ["HistoryOfProceduresSection" /* PROCEDURES */]: (resource) => resource.resourceType === "Procedure" && resource.status === "completed",
   // Only include social history Observations
@@ -142,7 +144,7 @@ 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
@@ -156,7 +158,7 @@ var IPSSectionSummaryCompositionFilter = {
   ["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)),
+  // [IPSSections.DIAGNOSTIC_REPORTS]: (resource) => resource.resourceType === 'Composition' && resource.type?.coding?.some((c: any) => 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 {
@@ -620,9 +622,18 @@ var TemplateUtilities = class {
     }
     return status;
   }
+  formatFloatValue(value) {
+    if (typeof value === "number") {
+      return value.toFixed(2).replace(/\.?0+$/, "");
+    } else if (typeof value === "string" && !isNaN(Number(value))) {
+      return parseFloat(value).toFixed(2).replace(/\.?0+$/, "");
+    }
+    return value;
+  }
   extractObservationSummaryValue(data, timezone) {
     if (data["valueQuantity.value"] !== void 0) {
-      const value = data["valueQuantity.value"];
+      let value = data["valueQuantity.value"];
+      value = this.formatFloatValue(value);
       const unit = data["valueQuantity.unit"];
       return unit ? `${value} ${unit}` : `${value}`;
     }
@@ -639,7 +650,9 @@ var TemplateUtilities = class {
       return String(data["valueBoolean"]);
     }
     if (data["valueInteger"] !== void 0) {
-      return String(data["valueInteger"]);
+      let value = String(data["valueInteger"]);
+      value = this.formatFloatValue(value);
+      return value;
     }
     if (data["valueDateTime"] !== void 0) {
       return this.renderTime(data["valueDateTime"], timezone);
@@ -659,7 +672,8 @@ var TemplateUtilities = class {
       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"];
+      let originValue = data["valueSampledData.origin.value"];
+      originValue = this.formatFloatValue(originValue);
       const originUnit = data["valueSampledData.origin.unit"];
       let result = "";
       if (originValue !== void 0 && originUnit !== void 0) {
@@ -669,10 +683,10 @@ var TemplateUtilities = class {
       } 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 period = this.formatFloatValue(data["valueSampledData.period"]);
+      const factor = this.formatFloatValue(data["valueSampledData.factor"]);
+      const lowerLimit = this.formatFloatValue(data["valueSampledData.lowerLimit"]);
+      const upperLimit = this.formatFloatValue(data["valueSampledData.upperLimit"]);
       const sampledData = data["valueSampledData.data"];
       const extras = [];
       if (period !== void 0) extras.push(`period: ${period}`);
@@ -708,14 +722,14 @@ var TemplateUtilities = class {
     if (data["valueRatio.numerator.value"] !== void 0 || data["valueRatio.denominator.value"] !== void 0) {
       let ratio = "";
       if (data["valueRatio.numerator.value"] !== void 0) {
-        ratio += `${data["valueRatio.numerator.value"]}`;
+        ratio += `${this.formatFloatValue(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"]}`;
+        ratio += `${this.formatFloatValue(data["valueRatio.denominator.value"])}`;
         if (data["valueRatio.denominator.unit"] !== void 0) {
           ratio += ` ${data["valueRatio.denominator.unit"]}`;
         }
@@ -969,6 +983,313 @@ var TemplateUtilities = class {
 
 // src/constants.ts
 var ADDRESS_SIMILARITY_THRESHOLD = 70;
+var LAB_LOINC_MAP = {
+  // METABOLIC PANELS (VERY COMMONLY ORDERED)
+  "Basic Metabolic Panel": [
+    "24321-2",
+    // Basic metabolic 2000 panel - Serum or Plasma
+    "51990-0"
+    // Basic metabolic 2000 panel - Blood
+  ],
+  "Comprehensive Metabolic Panel": [
+    "24323-8"
+    // Comprehensive metabolic 2000 panel - Serum or Plasma
+  ],
+  // CBC COMPONENTS
+  Hemoglobin: [
+    "718-7"
+    // Hemoglobin [Mass/volume] in Blood
+  ],
+  Hematocrit: [
+    "4544-3"
+    // Hematocrit [Volume Fraction] of Blood by Automated count
+  ],
+  "White Blood Cell Count": [
+    "6690-2"
+    // Leukocytes [///volume] in Blood by Automated count
+  ],
+  "Platelet Count": [
+    "777-3"
+    // Platelets [///volume] in Blood by Automated count
+  ],
+  "Complete Blood Count": [
+    "58410-2",
+    // CBC panel - Blood by Automated count
+    "57021-8",
+    // CBC W Auto Differential panel - Blood
+    "69738-3"
+    // CBC W Auto Differential panel - Blood by Automated count
+  ],
+  // CHEMISTRY - GLUCOSE
+  Glucose: [
+    "2345-7",
+    // Glucose [Mass/volume] in Serum or Plasma
+    "1558-6",
+    // Fasting glucose [Mass/volume] in Serum or Plasma
+    "2339-0"
+    // Glucose [Mass/volume] in Blood
+  ],
+  // RENAL FUNCTION
+  Creatinine: [
+    "2160-0"
+    // Creatinine [Mass/volume] in Serum or Plasma
+  ],
+  "Blood Urea Nitrogen": [
+    "3094-0",
+    // Urea nitrogen [Mass/volume] in Serum or Plasma
+    "6299-2"
+    // Urea nitrogen [Mass/volume] in Blood
+  ],
+  // ELECTROLYTES
+  Sodium: [
+    "2951-2"
+    // Sodium [Moles/volume] in Serum or Plasma
+  ],
+  Potassium: [
+    "2823-3"
+    // Potassium [Moles/volume] in Serum or Plasma
+  ],
+  Chloride: [
+    "2075-0"
+    // Chloride [Moles/volume] in Serum or Plasma
+  ],
+  Calcium: [
+    "17861-6",
+    // Calcium [Mass/volume] in Serum or Plasma
+    "1994-3"
+    // Calcium.ionized [Moles/volume] in Serum or Plasma
+  ],
+  Magnesium: [
+    "19123-9"
+    // Magnesium [Mass/volume] in Serum or Plasma
+  ],
+  Phosphate: [
+    "14879-1"
+    // Phosphate [Mass/volume] in Serum or Plasma
+  ],
+  // PROTEINS
+  Albumin: [
+    "1751-7"
+    // Albumin [Mass/volume] in Serum or Plasma
+  ],
+  "Total Protein": [
+    "2885-2"
+    // Protein [Mass/volume] in Serum or Plasma
+  ],
+  // LIVER FUNCTION
+  Bilirubin: [
+    "1975-2",
+    // Bilirubin.total [Mass/volume] in Serum or Plasma
+    "1968-7",
+    // Bilirubin.direct [Mass/volume] in Serum or Plasma
+    "1971-1"
+    // Bilirubin.indirect [Mass/volume] in Serum or Plasma
+  ],
+  "Alkaline Phosphatase": [
+    "6768-6"
+    // Alkaline phosphatase [Enzymatic activity/volume] in Serum or Plasma
+  ],
+  AST: [
+    "1920-8"
+    // Aspartate aminotransferase [Enzymatic activity/volume] in Serum or Plasma
+  ],
+  ALT: [
+    "1742-6"
+    // Alanine aminotransferase [Enzymatic activity/volume] in Serum or Plasma
+  ],
+  GGT: [
+    "2324-2"
+    // Gamma glutamyl transferase [Enzymatic activity/volume] in Serum or Plasma
+  ],
+  // ENDOCRINE
+  TSH: [
+    "3016-3"
+    // Thyrotropin [Units/volume] in Serum or Plasma
+  ],
+  "Free T4": [
+    "3024-7"
+    // Thyroxine (T4) free [Mass/volume] in Serum or Plasma
+  ],
+  "Total T4": [
+    "3026-2"
+    // Thyroxine (T4) [Mass/volume] in Serum or Plasma
+  ],
+  "Free T3": [
+    "3051-0"
+    // Triiodothyronine (T3) free [Mass/volume] in Serum or Plasma
+  ],
+  "Total T3": [
+    "3053-6"
+    // Triiodothyronine (T3) [Mass/volume] in Serum or Plasma
+  ],
+  HbA1c: [
+    "4548-4",
+    // Hemoglobin A1c/Hemoglobin.total in Blood
+    "17856-6"
+    // Hemoglobin A1c/Hemoglobin.total in Blood by HPLC
+  ],
+  // LIPID PANEL
+  "Lipid Panel": [
+    "24331-1",
+    // Lipid 1996 panel - Serum or Plasma
+    "57698-3"
+    // Lipid panel with direct LDL - Serum or Plasma
+  ],
+  "Cholesterol Total": [
+    "2093-3"
+    // Cholesterol [Mass/volume] in Serum or Plasma
+  ],
+  "HDL Cholesterol": [
+    "2085-9"
+    // Cholesterol in HDL [Mass/volume] in Serum or Plasma
+  ],
+  "LDL Cholesterol": [
+    "13457-7",
+    // Cholesterol in LDL [Mass/volume] in Serum or Plasma by calculation
+    "18262-6"
+    // Cholesterol in LDL [Mass/volume] in Serum or Plasma by Direct assay
+  ],
+  Triglycerides: [
+    "2571-8"
+    // Triglyceride [Mass/volume] in Serum or Plasma
+  ],
+  // COAGULATION STUDIES (COMMONLY MISSING!)
+  PT: [
+    "5902-2"
+    // Prothrombin time (PT)
+  ],
+  INR: [
+    "6301-6"
+    // INR in Platelet poor plasma by Coagulation assay
+  ],
+  PTT: [
+    "3173-2",
+    // aPTT in Blood by Coagulation assay
+    "14979-9"
+    // aPTT in Platelet poor plasma by Coagulation assay
+  ],
+  Fibrinogen: [
+    "3255-7"
+    // Fibrinogen [Mass/volume] in Platelet poor plasma by Coagulation assay
+  ],
+  "D-Dimer": [
+    "48065-7",
+    // D-dimer FEU [Mass/volume] in Platelet poor plasma
+    "48066-5"
+    // D-dimer DDU [Mass/volume] in Platelet poor plasma
+  ],
+  // CARDIAC MARKERS (CRITICAL FOR ER!)
+  "Troponin I": [
+    "10839-9",
+    // Troponin I.cardiac [Mass/volume] in Serum or Plasma
+    "42757-5",
+    // Troponin I.cardiac [Mass/volume] in Blood
+    "89579-7"
+    // Troponin I.cardiac [Mass/volume] in Serum or Plasma by High sensitivity method
+  ],
+  "Troponin T": [
+    "6598-7",
+    // Troponin T.cardiac [Mass/volume] in Serum or Plasma
+    "48425-3"
+    // Troponin T.cardiac [Mass/volume] in Serum or Plasma by High sensitivity method
+  ],
+  BNP: [
+    "30934-4"
+    // BNP [Mass/volume] in Serum or Plasma
+  ],
+  "NT-proBNP": [
+    "33762-6"
+    // NT-proBNP [Mass/volume] in Serum or Plasma
+  ],
+  "CK-MB": [
+    "13969-1"
+    // Creatine kinase.MB [Mass/volume] in Serum or Plasma
+  ],
+  // INFLAMMATORY MARKERS
+  CRP: [
+    "1988-5",
+    // C reactive protein [Mass/volume] in Serum or Plasma
+    "30522-7"
+    // C reactive protein [Mass/volume] in Serum or Plasma by High sensitivity method
+  ],
+  ESR: [
+    "30341-2",
+    // Erythrocyte sedimentation rate by Westergren method
+    "4537-7"
+    // Erythrocyte sedimentation rate
+  ],
+  // VITAMINS & MINERALS (VERY HIGH VOLUME!)
+  "Vitamin D": [
+    "1990-1",
+    // Vitamin D [Mass/volume] in Serum or Plasma (obsolete, but still used)
+    "14635-7",
+    // 25-Hydroxyvitamin D3 [Mass/volume] in Serum or Plasma
+    "62292-8"
+    // 25-Hydroxyvitamin D2+D3 [Mass/volume] in Serum or Plasma
+  ],
+  "Vitamin B12": [
+    "2132-9"
+    // Cobalamin (Vitamin B12) [Mass/volume] in Serum or Plasma
+  ],
+  Folate: [
+    "2284-8",
+    // Folate [Mass/volume] in Serum or Plasma
+    "15152-2"
+    // Folate [Mass/volume] in Red Blood Cells
+  ],
+  Iron: [
+    "2498-4"
+    // Iron [Mass/volume] in Serum or Plasma
+  ],
+  Ferritin: [
+    "2276-4"
+    // Ferritin [Mass/volume] in Serum or Plasma
+  ],
+  TIBC: [
+    "2500-7"
+    // Iron binding capacity [Mass/volume] in Serum or Plasma
+  ],
+  // OTHER COMMON TESTS
+  PSA: [
+    "2857-1",
+    // Prostate specific Ag [Mass/volume] in Serum or Plasma
+    "10886-0"
+    // Prostate specific Ag Free [Mass/volume] in Serum or Plasma
+  ],
+  "Uric Acid": [
+    "3084-1"
+    // Urate [Mass/volume] in Serum or Plasma
+  ],
+  LDH: [
+    "2532-0",
+    // Lactate dehydrogenase [Enzymatic activity/volume] in Serum or Plasma
+    "14804-9"
+    // Lactate dehydrogenase [Enzymatic activity/volume] in Serum or Plasma by Lactate to pyruvate reaction
+  ],
+  Amylase: [
+    "1798-8"
+    // Amylase [Enzymatic activity/volume] in Serum or Plasma
+  ],
+  Lipase: [
+    "3040-3"
+    // Lipase [Enzymatic activity/volume] in Serum or Plasma
+  ],
+  hCG: [
+    "21198-7",
+    // Choriogonadotropin.beta subunit [Units/volume] in Serum or Plasma
+    "2118-8",
+    // Choriogonadotropin (pregnancy test) [Presence] in Serum or Plasma
+    "2106-3"
+    // Choriogonadotropin (pregnancy test) [Presence] in Urine
+  ],
+  // URINALYSIS
+  Urinalysis: [
+    "24357-6",
+    // Urinalysis macro (dipstick) panel - Urine
+    "24356-8"
+    // Urinalysis complete panel - Urine
+  ]
+};
 
 // src/narratives/templates/typescript/PatientTemplate.ts
 var PatientTemplate = class _PatientTemplate {
@@ -1887,8 +2208,8 @@ 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 += `
@@ -1901,12 +2222,17 @@ 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>`;
@@ -2088,6 +2414,12 @@ var MedicalDevicesTemplate = class _MedicalDevicesTemplate {
 };
 
 // src/narratives/templates/typescript/DiagnosticResultsTemplate.ts
+var loincToLabName = {};
+for (const [labName, loincCodes] of Object.entries(LAB_LOINC_MAP)) {
+  for (const code of loincCodes) {
+    loincToLabName[code] = labName;
+  }
+}
 var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
   /**
    * Generate HTML narrative for Diagnostic Results
@@ -2390,8 +2722,8 @@ 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 = {};
@@ -2431,7 +2763,6 @@ 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);
@@ -2440,48 +2771,59 @@ 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>
@@ -2490,7 +2832,7 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
     }
     html += `
       </div>`;
-    return observationExists || diagnosticReportExists ? html : void 0;
+    return observationAdded.size > 0 || diagnosticReportAdded.size > 0 ? html : void 0;
   }
   /**
    * Internal static implementation that actually generates the narrative
@@ -2504,30 +2846,80 @@ 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;
-        return dateA && dateB ? new Date(dateB).getTime() - new Date(dateA).getTime() : 0;
+        const dateA = this.getObservationDate(a);
+        const dateB = this.getObservationDate(b);
+        return dateA && dateB ? dateB.getTime() - dateA.getTime() : 0;
       });
+      this.filterObservationForLoincCodes(observations);
       html += this.renderObservations(templateUtilities, observations, timezone);
     }
-    const diagnosticReports = this.getDiagnosticReports(resources);
-    if (diagnosticReports.length > 0) {
-      diagnosticReports.sort((a, b) => {
-        const dateA = a.issued;
-        const dateB = b.issued;
-        return dateA && dateB ? new Date(dateB).getTime() - new Date(dateA).getTime() : 0;
-      });
-      html += this.renderDiagnosticReports(templateUtilities, diagnosticReports, timezone);
+    if (process.env.ENABLE_DIAGNOSTIC_REPORTS_IN_SUMMARY === "true") {
+      const diagnosticReports = this.getDiagnosticReports(resources);
+      if (diagnosticReports.length > 0) {
+        diagnosticReports.sort((a, b) => {
+          const dateA = a.issued;
+          const dateB = b.issued;
+          return dateA && dateB ? new Date(dateB).getTime() - new Date(dateA).getTime() : 0;
+        });
+        html += this.renderDiagnosticReports(templateUtilities, diagnosticReports, timezone);
+      }
     }
     return html;
   }
+  static filterObservationForLoincCodes(observations) {
+    const labsAdded = /* @__PURE__ */ new Set();
+    const filteredObservations = [];
+    for (const obs of observations) {
+      const loincCode = this.getObservationLoincCode(obs);
+      if (loincCode && loincToLabName[loincCode]) {
+        const labName = loincToLabName[loincCode];
+        if (!labsAdded.has(labName)) {
+          labsAdded.add(labName);
+          filteredObservations.push(obs);
+        }
+      }
+    }
+    observations.length = 0;
+    observations.push(...filteredObservations);
+  }
+  static getObservationLoincCode(obs) {
+    if (obs.code && obs.code.coding) {
+      for (const coding of obs.code.coding) {
+        if (coding.system && coding.system.toLowerCase().includes("loinc") && coding.code) {
+          return coding.code;
+        }
+      }
+    }
+    return void 0;
+  }
+  static getObservationDate(obs) {
+    let obsDate = void 0;
+    if (obs.effectiveDateTime) {
+      obsDate = new Date(obs.effectiveDateTime);
+    } else if (obs.effectivePeriod) {
+      if (obs.effectivePeriod.start) {
+        obsDate = new Date(obs.effectivePeriod.start);
+      } else if (obs.effectivePeriod.end) {
+        obsDate = new Date(obs.effectivePeriod.end);
+      }
+    }
+    return obsDate;
+  }
   /**
   * 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);
+    return resources.filter((resourceItem) => {
+      if (resourceItem.resourceType === "Observation") {
+        const obsDate = this.getObservationDate(resourceItem);
+        if (obsDate && obsDate >= new Date(Date.now() - RESULT_SUMMARY_OBSERVATION_DATE_FILTER)) {
+          return true;
+        }
+      }
+      return false;
+    }).map((resourceItem) => resourceItem);
   }
   /**
    * Get all DiagnosticReport resources from the resource array
@@ -2545,32 +2937,35 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
    * @returns HTML string for rendering
    */
   static renderObservations(templateUtilities, observations, timezone) {
-    let html = `
-      <h3>Observations</h3>
+    let html = "";
+    if (process.env.ENABLE_DIAGNOSTIC_REPORTS_IN_SUMMARY === "true") {
+      html += `
+      <h3>Observations</h3>`;
+    }
+    html += `
       <table>
         <thead>
           <tr>
             <th>Code</th>
             <th>Result</th>
-            <th>Unit</th>
-            <th>Interpretation</th>
             <th>Reference Range</th>
-            <th>Comments</th>
             <th>Date</th>
           </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.concatReferenceRange(obs.referenceRange)}</td>
+            <td>${obs.effectiveDateTime ? templateUtilities.renderTime(obs.effectiveDateTime, timezone) : obs.effectivePeriod ? templateUtilities.renderPeriod(obs.effectivePeriod, timezone) : ""}</td>
+          </tr>`;
+      }
     }
     html += `
         </tbody>
@@ -2597,18 +2992,23 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
           </tr>
         </thead>
         <tbody>`;
+    const diagnosticReportAdded = /* @__PURE__ */ new Set();
     for (const report of reports) {
-      let resultCount = "";
-      if (report.result && Array.isArray(report.result)) {
-        resultCount = `${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>${report.issued ? templateUtilities.renderTime(report.issued, timezone) : ""}</td>
-        </tr>`;
     }
     html += `
         </tbody>
@@ -2788,8 +3188,8 @@ var PastHistoryOfIllnessTemplate = class {
     let html = ``;
     const resolvedConditions = resources.map((entry) => entry) || [];
     resolvedConditions.sort((a, b) => {
-      const dateA = a.onsetDateTime ? new Date(a.onsetDateTime).getTime() : 0;
-      const dateB = b.onsetDateTime ? new Date(b.onsetDateTime).getTime() : 0;
+      const dateA = a.recordedDate ? new Date(a.recordedDate).getTime() : 0;
+      const dateB = b.recordedDate ? new Date(b.recordedDate).getTime() : 0;
       return dateB - dateA;
     });
     html += `
@@ -2803,13 +3203,18 @@ var PastHistoryOfIllnessTemplate = class {
             </tr>
           </thead>
           <tbody>`;
+    const addedConditionCodes = /* @__PURE__ */ new Set();
     for (const cond of resolvedConditions) {
-      html += `<tr id="${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">${templateUtilities.renderDate(cond.abatementDateTime)}</td>
+          </tr>`;
+      }
     }
     html += `</tbody>
         </table>`;
@@ -2934,20 +3339,14 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
     const clinicalImpressions = [];
     for (const resourceItem of resources) {
       if (resourceItem.resourceType === "Condition") {
-        const cond = resourceItem;
-        const isResolved = cond.clinicalStatus?.coding?.some(
-          (c) => c.code === "resolved" || c.code === "inactive" || c.display?.toLowerCase().includes("resolved")
-        );
-        if (!isResolved) {
-          activeConditions.push(cond);
-        }
+        activeConditions.push(resourceItem);
       } else if (resourceItem.resourceType === "ClinicalImpression") {
         clinicalImpressions.push(resourceItem);
       }
     }
     activeConditions.sort((a, b) => {
-      const dateA = a.onsetDateTime ? new Date(a.onsetDateTime).getTime() : 0;
-      const dateB = b.onsetDateTime ? new Date(b.onsetDateTime).getTime() : 0;
+      const dateA = a.recordedDate ? new Date(a.recordedDate).getTime() : 0;
+      const dateB = b.recordedDate ? new Date(b.recordedDate).getTime() : 0;
       return dateB - dateA;
     });
     clinicalImpressions.sort((a, b) => {
@@ -2966,12 +3365,17 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
             </tr>
           </thead>
           <tbody>`;
+      const addedConditionCodes = /* @__PURE__ */ new Set();
       for (const cond of activeConditions) {
-        html += `<tr id="${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>`;