@imranq2/fhirpatientsummary 1.0.26 → 1.0.28

package/dist/index.js

@@ -87,6 +87,8 @@ 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
@@ -106,7 +108,7 @@ 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
@@ -128,7 +130,7 @@ 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 {
@@ -218,7 +220,7 @@ var TemplateUtilities = class {
   renderOrganization(orgRef) {
     const organization = orgRef && this.resolveReference(orgRef);
     if (organization && organization.resourceType === "Organization" && organization.name) {
-      return organization.name;
+      return this.renderTextAsHtml(organization.name);
     }
     return "";
   }
@@ -230,7 +232,7 @@ var TemplateUtilities = class {
   renderVaccineManufacturer(immunization) {
     const organization = immunization.manufacturer && this.resolveReference(immunization.manufacturer);
     if (organization && organization.resourceType === "Organization" && organization.name) {
-      return organization.name;
+      return this.renderTextAsHtml(organization.name);
     }
     return "";
   }
@@ -269,7 +271,7 @@ var TemplateUtilities = class {
    */
   renderMedicationCode(medication) {
     if (medication && medication.code) {
-      return this.codeableConcept(medication.code, "display");
+      return this.renderTextAsHtml(this.codeableConcept(medication.code, "display"));
     }
     return "";
   }
@@ -280,7 +282,7 @@ var TemplateUtilities = class {
    */
   renderDoseNumber(doseNumber) {
     if (doseNumber && doseNumber.value !== void 0) {
-      return doseNumber.value.toString();
+      return this.renderTextAsHtml(doseNumber.value.toString());
     }
     return "";
   }
@@ -291,7 +293,7 @@ var TemplateUtilities = class {
    */
   renderValueUnit(value) {
     if (value && value.constructor?.name === "Quantity" && value.unit) {
-      return value.unit;
+      return this.renderTextAsHtml(value.unit);
     }
     return "";
   }
@@ -357,7 +359,7 @@ var TemplateUtilities = class {
    * @returns Comma-separated string of items
    */
   safeConcat(list, attr) {
-    return this.concat(list || [], attr);
+    return this.renderTextAsHtml(this.concat(list || [], attr));
   }
   /**
    * Concatenates text from a list of CodeableConcept objects
@@ -374,7 +376,7 @@ var TemplateUtilities = class {
         items.push(item.text);
       }
     }
-    return items.join(", ");
+    return this.renderTextAsHtml(items.join(", "));
   }
   /**
    * Concatenates reaction manifestations
@@ -395,7 +397,7 @@ var TemplateUtilities = class {
         }
       }
     }
-    return texts.join(", ");
+    return this.renderTextAsHtml(texts.join(", "));
   }
   /**
    * Concatenates dose numbers
@@ -412,7 +414,7 @@ var TemplateUtilities = class {
         doseNumbers.push(item.doseNumberPositiveInt.toString());
       }
     }
-    return doseNumbers.join(", ");
+    return this.renderTextAsHtml(doseNumbers.join(", "));
   }
   /**
    * Concatenates dosage routes
@@ -429,7 +431,7 @@ var TemplateUtilities = class {
         routes.push(item.route.text);
       }
     }
-    return routes.join(", ");
+    return this.renderTextAsHtml(routes.join(", "));
   }
   /**
    * Returns the first item from a list of CodeableConcept objects
@@ -438,7 +440,7 @@ var TemplateUtilities = class {
    */
   firstFromCodeableConceptList(list) {
     if (list && Array.isArray(list) && list[0]) {
-      return this.codeableConcept(list[0], "display");
+      return this.renderTextAsHtml(this.codeableConcept(list[0], "display"));
     }
     return "";
   }
@@ -457,7 +459,7 @@ var TemplateUtilities = class {
         texts.push(item.text);
       }
     }
-    return texts.join(", ");
+    return this.renderTextAsHtml(texts.join(", "));
   }
   /**
    * Renders component codes
@@ -592,9 +594,18 @@ 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}`;
     }
@@ -611,7 +622,9 @@ 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);
@@ -631,7 +644,8 @@ 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) {
@@ -641,10 +655,10 @@ 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: ${period}`);
@@ -680,14 +694,14 @@ var TemplateUtilities = class {
     if (data["valueRatio.numerator.value"] !== void 0 || data["valueRatio.denominator.value"] !== void 0) {
       let ratio = "";
       if (data["valueRatio.numerator.value"] !== void 0) {
-        ratio += `${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"]}`;
         }
@@ -777,9 +791,11 @@ var TemplateUtilities = class {
     return "";
   }
   /**
-   * Renders text as HTML, escaping special characters and replacing newlines with <br />
-   * @param text - The text to render
-   * @private
+   * Public method to render plain text as HTML, escaping special characters and replacing newlines with <br />.
+   * This method should be used whenever displaying user-supplied or FHIR resource text in HTML to prevent XSS vulnerabilities
+   * and to preserve formatting. Use this in templates or UI components that need to safely display multi-line or arbitrary text.
+   * @param text - The text to render as HTML
+   * @returns The HTML-safe string with newlines converted to <br />
    */
   renderTextAsHtml(text) {
     if (!text || text.trim() === "") {
@@ -843,7 +859,7 @@ var TemplateUtilities = class {
         dateTime = DateTime.fromISO(String(dateValue));
       }
       if (!dateTime.isValid) {
-        return String(dateValue);
+        return this.renderTextAsHtml(String(dateValue));
       }
       if (dateOnly) {
         dateTime = dateTime.toUTC();
@@ -859,9 +875,9 @@ var TemplateUtilities = class {
         hour12: true,
         timeZoneName: "short"
       };
-      return dateTime.toLocaleString(formatOptions);
+      return this.renderTextAsHtml(dateTime.toLocaleString(formatOptions));
     } catch {
-      return String(dateValue);
+      return this.renderTextAsHtml(String(dateValue));
     }
   }
   /**
@@ -941,6 +957,313 @@ 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 {
@@ -1258,7 +1581,7 @@ var PatientTemplate = class _PatientTemplate {
     const uniqueLanguages = /* @__PURE__ */ new Set();
     const preferredLanguages = /* @__PURE__ */ new Set();
     patient.communication.forEach((comm) => {
-      const language = templateUtilities.codeableConcept(comm.language);
+      const language = templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(comm.language));
       if (language) {
         if (comm.preferred) {
           preferredLanguages.add(language);
@@ -1316,13 +1639,13 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
         for (const columnData of rowData.section ?? []) {
           switch (columnData.title) {
             case "Allergen Name":
-              data["allergen"] = columnData.text?.div ?? "";
+              data["allergen"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
               break;
             case "Criticality":
-              data["criticality"] = columnData.text?.div ?? "";
+              data["criticality"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
               break;
             case "Recorded Date":
-              data["recordedDate"] = columnData.text?.div ?? "";
+              data["recordedDate"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
               break;
             default:
               break;
@@ -1443,11 +1766,11 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
     for (const allergy of allergies) {
       html += `
         <tr id="${templateUtilities.narrativeLinkId(allergy.extension)}">
-          <td class="Name"><span class="AllergenName">${templateUtilities.codeableConcept(allergy.code)}</span></td>
-          <td class="Status">${templateUtilities.codeableConcept(allergy.clinicalStatus) || "-"}</td>
-          <td class="Category">${templateUtilities.safeConcat(allergy.category) || "-"}</td>
-          <td class="Reaction">${templateUtilities.concatReactionManifestation(allergy.reaction) || "-"}</td>
-          <td class="OnsetDate">${templateUtilities.renderTime(allergy.onsetDateTime, timezone) || "-"}</td>
+          <td class="Name"><span class="AllergenName">${templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(allergy.code))}</span></td>
+          <td class="Status">${templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(allergy.clinicalStatus)) || "-"}</td>
+          <td class="Category">${templateUtilities.renderTextAsHtml(templateUtilities.safeConcat(allergy.category)) || "-"}</td>
+          <td class="Reaction">${templateUtilities.renderTextAsHtml(templateUtilities.concatReactionManifestation(allergy.reaction)) || "-"}</td>
+          <td class="OnsetDate">${templateUtilities.renderTextAsHtml(templateUtilities.renderTime(allergy.onsetDateTime, timezone)) || "-"}</td>
           <td class="Comments">${templateUtilities.renderNotes(allergy.note, timezone, { styled: true, warning: true })}</td>`;
       if (includeResolved) {
         let endDate = "-";
@@ -1460,7 +1783,7 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
           }
         }
         html += `
-          <td class="ResolvedDate">${endDate}</td>`;
+          <td class="ResolvedDate">${templateUtilities.renderTextAsHtml(endDate)}</td>`;
       }
       html += `</tr>`;
     }
@@ -1483,17 +1806,21 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
    * 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')
+   * @param now - Optional current date to use for calculations (defaults to new Date())
    * @returns HTML string for rendering
    */
-  generateSummaryNarrative(resources, timezone) {
+  generateSummaryNarrative(resources, timezone, now) {
     const templateUtilities = new TemplateUtilities(resources);
     let isSummaryCreated = false;
+    const currentDate = now || /* @__PURE__ */ new Date();
+    const twelveMonthsAgo = new Date(currentDate.getFullYear(), currentDate.getMonth() - 12, currentDate.getDate());
     let html = `
         <div>
             <table>
             <thead>
                 <tr>
                 <th>Medication</th>
+                <th>Status</th>
                 <th>Sig</th>
                 <th>Days of Supply</th>
                 <th>Refills</th>
@@ -1507,40 +1834,48 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
         for (const columnData of rowData.section ?? []) {
           switch (columnData.title) {
             case "Medication Name":
-              data["medication"] = columnData.text?.div ?? "";
+              data["medication"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
               break;
             case "Status":
-              data["status"] = columnData.text?.div ?? "";
+              data["status"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
               break;
             case "Prescriber Instruction":
-              data["sig-prescriber"] = columnData.text?.div ?? "";
+              data["sig-prescriber"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
               break;
             case "Pharmacy Instruction":
-              data["sig-pharmacy"] = columnData.text?.div ?? "";
+              data["sig-pharmacy"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
               break;
             case "Days Of Supply":
-              data["daysOfSupply"] = columnData.text?.div ?? "";
+              data["daysOfSupply"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
               break;
             case "Refills Remaining":
-              data["refills"] = columnData.text?.div ?? "";
+              data["refills"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
               break;
             case "Authored On Date":
-              data["startDate"] = columnData.text?.div ?? "";
+              data["startDate"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
               break;
             default:
               break;
           }
         }
-        if (data["status"] === "active") {
+        let startDateObj;
+        if (data["startDate"]) {
+          startDateObj = new Date(data["startDate"]);
+          if (isNaN(startDateObj.getTime())) {
+            startDateObj = void 0;
+          }
+        }
+        if (data["status"] === "active" || startDateObj && startDateObj >= twelveMonthsAgo) {
           isSummaryCreated = true;
           html += `
-                    <tr>
-                        <td>${data["medication"]}</td>
-                        <td>${data["sig-prescriber"] || data["sig-pharmacy"]}</td>
-                        <td>${data["daysOfSupply"]}</td>
-                        <td>${data["refills"]}</td>
-                        <td>${templateUtilities.renderTime(data["startDate"], timezone)}</td>
-                    </tr>`;
+                            <tr>
+                                <td>${templateUtilities.renderTextAsHtml(data["medication"])}</td>
+                                <td>${templateUtilities.renderTextAsHtml(data["status"])}</td>
+                                <td>${templateUtilities.renderTextAsHtml(data["sig-prescriber"] || data["sig-pharmacy"])}</td>
+                                <td>${templateUtilities.renderTextAsHtml(data["daysOfSupply"])}</td>
+                                <td>${templateUtilities.renderTextAsHtml(data["refills"])}</td>
+                                <td>${templateUtilities.renderTime(data["startDate"], timezone)}</td>
+                            </tr>`;
         }
       }
     }
@@ -1762,13 +2097,13 @@ var ImmunizationsTemplate = class _ImmunizationsTemplate {
         for (const columnData of rowData.section ?? []) {
           switch (columnData.title) {
             case "Immunization Name":
-              data["immunization"] = columnData.text?.div ?? "";
+              data["immunization"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
               break;
             case "Status":
-              data["status"] = columnData.text?.div ?? "";
+              data["status"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
               break;
             case "occurrenceDateTime":
-              data["occurrenceDateTime"] = columnData.text?.div ?? "";
+              data["occurrenceDateTime"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
               break;
             default:
               break;
@@ -1819,7 +2154,7 @@ var ImmunizationsTemplate = class _ImmunizationsTemplate {
         const imm = resourceItem;
         html += `
           <tr id="${templateUtilities.narrativeLinkId(imm)}">
-            <td>${templateUtilities.codeableConcept(imm.vaccineCode)}</td>
+            <td>${templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(imm.vaccineCode))}</td>
             <td>${imm.status || ""}</td>
             <td>${templateUtilities.concatDoseNumber(imm.protocolApplied)}</td>
             <td>${templateUtilities.renderVaccineManufacturer(imm)}</td>
@@ -1875,7 +2210,7 @@ var ProblemListTemplate = class _ProblemListTemplate {
           <tbody>`;
     const addedConditionCodes = /* @__PURE__ */ new Set();
     for (const cond of activeConditions) {
-      const conditionCode = templateUtilities.codeableConcept(cond.code);
+      const conditionCode = templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(cond.code));
       if (!addedConditionCodes.has(conditionCode)) {
         addedConditionCodes.add(conditionCode);
         html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
@@ -1935,7 +2270,7 @@ var VitalSignsTemplate = class _VitalSignsTemplate {
               const vitalData = {};
               for (const component of columnData.section?.[0]?.section ?? []) {
                 if (component.title) {
-                  vitalData[component.title] = component.text?.div ?? "";
+                  vitalData[component.title] = templateUtilities.renderTextAsHtml(component.text?.div ?? "");
                 }
               }
               const vitalValue = templateUtilities.extractObservationSummaryValue(
@@ -1947,7 +2282,7 @@ var VitalSignsTemplate = class _VitalSignsTemplate {
                 data[dataKey] = vitalValue;
               }
             }
-            data[columnTitle] = columnData.text?.div ?? "";
+            data[columnTitle] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
           }
         }
         isSummaryCreated = true;
@@ -1997,7 +2332,7 @@ var VitalSignsTemplate = class _VitalSignsTemplate {
     for (const obs of observations) {
       html += `
           <tr id="${templateUtilities.narrativeLinkId(obs)}">
-            <td>${templateUtilities.codeableConcept(obs.code, "display")}</td>
+            <td>${templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(obs.code, "display"))}</td>
             <td>${templateUtilities.extractObservationValue(obs)}</td>
             <td>${templateUtilities.extractObservationValueUnit(obs)}</td>
             <td>${templateUtilities.firstFromCodeableConceptList(obs.interpretation)}</td>
@@ -2051,10 +2386,10 @@ var MedicalDevicesTemplate = class _MedicalDevicesTemplate {
     for (const dus of deviceStatements) {
       html += `
         <tr id="${templateUtilities.narrativeLinkId(dus)}">
-          <td>${templateUtilities.renderDevice(dus.device)}</td>
-          <td>${dus.status || ""}</td>
+          <td>${templateUtilities.renderTextAsHtml(templateUtilities.renderDevice(dus.device))}</td>
+          <td>${templateUtilities.renderTextAsHtml(dus.status || "")}</td>
           <td>${templateUtilities.renderNotes(dus.note, timezone)}</td>
-          <td>${templateUtilities.renderRecorded(dus.recordedOn, timezone)}</td>
+          <td>${templateUtilities.renderTextAsHtml(templateUtilities.renderRecorded(dus.recordedOn, timezone))}</td>
         </tr>`;
     }
     html += `
@@ -2065,6 +2400,12 @@ 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
@@ -2184,149 +2525,150 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
    * Helper function to extract observation field data
    * @param column - Column data from the summary
    * @param targetData - Record to populate with extracted data
+   * @param templateUtilities - Instance of TemplateUtilities for utility functions
    */
-  extractSummaryObservationFields(column, targetData) {
+  extractSummaryObservationFields(column, targetData, templateUtilities) {
     switch (column.title) {
       case "Labs Name":
-        targetData["code"] = column.text?.div ?? "";
+        targetData["code"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       case "effectiveDateTime":
-        targetData["effectiveDateTime"] = column.text?.div ?? "";
+        targetData["effectiveDateTime"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       case "effectivePeriod.start":
-        targetData["effectivePeriodStart"] = column.text?.div ?? "";
+        targetData["effectivePeriodStart"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       case "effectivePeriod.end":
-        targetData["effectivePeriodEnd"] = column.text?.div ?? "";
+        targetData["effectivePeriodEnd"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       // valueQuantity
       case "valueQuantity.value":
-        targetData["value"] = column.text?.div ?? "";
+        targetData["value"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         targetData["valueType"] = "valueQuantity";
         break;
       case "valueQuantity.unit":
-        targetData["unit"] = column.text?.div ?? "";
+        targetData["unit"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       // valueCodeableConcept
       case "valueCodeableConcept.text":
-        targetData["value"] = column.text?.div ?? "";
+        targetData["value"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         targetData["valueType"] = "valueCodeableConcept";
         break;
       case "valueCodeableConcept.coding.display":
         if (!targetData["value"]) {
-          targetData["value"] = column.text?.div ?? "";
+          targetData["value"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
           targetData["valueType"] = "valueCodeableConcept";
         }
         break;
       // valueString
       case "valueString":
-        targetData["value"] = column.text?.div ?? "";
+        targetData["value"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         targetData["valueType"] = "valueString";
         break;
       // valueBoolean
       case "valueBoolean":
-        targetData["value"] = column.text?.div ?? "";
+        targetData["value"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         targetData["valueType"] = "valueBoolean";
         break;
       // valueInteger
       case "valueInteger":
-        targetData["value"] = column.text?.div ?? "";
+        targetData["value"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         targetData["valueType"] = "valueInteger";
         break;
       // valueDateTime
       case "valueDateTime":
-        targetData["value"] = column.text?.div ?? "";
+        targetData["value"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         targetData["valueType"] = "valueDateTime";
         break;
       // valuePeriod
       case "valuePeriod.start":
-        targetData["valuePeriodStart"] = column.text?.div ?? "";
+        targetData["valuePeriodStart"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         targetData["valueType"] = "valuePeriod";
         break;
       case "valuePeriod.end":
-        targetData["valuePeriodEnd"] = column.text?.div ?? "";
+        targetData["valuePeriodEnd"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         targetData["valueType"] = "valuePeriod";
         break;
       // valueTime
       case "valueTime":
-        targetData["value"] = column.text?.div ?? "";
+        targetData["value"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         targetData["valueType"] = "valueTime";
         break;
       // valueSampledData
       case "valueSampledData.origin.value":
-        targetData["sampledDataOriginValue"] = column.text?.div ?? "";
+        targetData["sampledDataOriginValue"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         targetData["valueType"] = "valueSampledData";
         break;
       case "valueSampledData.origin.unit":
-        targetData["sampledDataOriginUnit"] = column.text?.div ?? "";
+        targetData["sampledDataOriginUnit"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       case "valueSampledData.period":
-        targetData["sampledDataPeriod"] = column.text?.div ?? "";
+        targetData["sampledDataPeriod"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       case "valueSampledData.factor":
-        targetData["sampledDataFactor"] = column.text?.div ?? "";
+        targetData["sampledDataFactor"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       case "valueSampledData.lowerLimit":
-        targetData["sampledDataLowerLimit"] = column.text?.div ?? "";
+        targetData["sampledDataLowerLimit"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       case "valueSampledData.upperLimit":
-        targetData["sampledDataUpperLimit"] = column.text?.div ?? "";
+        targetData["sampledDataUpperLimit"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       case "valueSampledData.data":
-        targetData["sampledDataData"] = column.text?.div ?? "";
+        targetData["sampledDataData"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       // valueRange
       case "valueRange.low.value":
-        targetData["valueRangeLowValue"] = column.text?.div ?? "";
+        targetData["valueRangeLowValue"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         targetData["valueType"] = "valueRange";
         break;
       case "valueRange.low.unit":
-        targetData["valueRangeLowUnit"] = column.text?.div ?? "";
+        targetData["valueRangeLowUnit"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       case "valueRange.high.value":
-        targetData["valueRangeHighValue"] = column.text?.div ?? "";
+        targetData["valueRangeHighValue"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       case "valueRange.high.unit":
-        targetData["valueRangeHighUnit"] = column.text?.div ?? "";
+        targetData["valueRangeHighUnit"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       // valueRatio
       case "valueRatio.numerator.value":
-        targetData["valueRatioNumeratorValue"] = column.text?.div ?? "";
+        targetData["valueRatioNumeratorValue"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         targetData["valueType"] = "valueRatio";
         break;
       case "valueRatio.numerator.unit":
-        targetData["valueRatioNumeratorUnit"] = column.text?.div ?? "";
+        targetData["valueRatioNumeratorUnit"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       case "valueRatio.denominator.value":
-        targetData["valueRatioDenominatorValue"] = column.text?.div ?? "";
+        targetData["valueRatioDenominatorValue"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       case "valueRatio.denominator.unit":
-        targetData["valueRatioDenominatorUnit"] = column.text?.div ?? "";
+        targetData["valueRatioDenominatorUnit"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       // referenceRange
       case "referenceRange.low.value":
-        targetData["referenceRangeLow"] = column.text?.div ?? "";
+        targetData["referenceRangeLow"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       case "referenceRange.low.unit":
-        targetData["referenceRangeLowUnit"] = column.text?.div ?? "";
+        targetData["referenceRangeLowUnit"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       case "referenceRange.high.value":
-        targetData["referenceRangeHigh"] = column.text?.div ?? "";
+        targetData["referenceRangeHigh"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       case "referenceRange.high.unit":
-        targetData["referenceRangeHighUnit"] = column.text?.div ?? "";
+        targetData["referenceRangeHighUnit"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       case "referenceRange.age.low.value":
-        targetData["referenceRangeAgeLowValue"] = column.text?.div ?? "";
+        targetData["referenceRangeAgeLowValue"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       case "referenceRange.age.low.unit":
-        targetData["referenceRangeAgeLowUnit"] = column.text?.div ?? "";
+        targetData["referenceRangeAgeLowUnit"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       case "referenceRange.age.high.value":
-        targetData["referenceRangeAgeHighValue"] = column.text?.div ?? "";
+        targetData["referenceRangeAgeHighValue"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       case "referenceRange.age.high.unit":
-        targetData["referenceRangeAgeHighUnit"] = column.text?.div ?? "";
+        targetData["referenceRangeAgeHighUnit"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
         break;
       default:
         break;
@@ -2379,28 +2721,28 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
               for (const componentSection of columnData.section) {
                 const componentData = {};
                 for (const nestedColumn of componentSection.section ?? []) {
-                  this.extractSummaryObservationFields(nestedColumn, componentData);
+                  this.extractSummaryObservationFields(nestedColumn, componentData, templateUtilities);
                 }
                 if (Object.keys(componentData).length > 0) {
                   components.push(componentData);
                 }
               }
             } else {
-              this.extractSummaryObservationFields(columnData, data);
+              this.extractSummaryObservationFields(columnData, data, templateUtilities);
             }
           } else if (resourceItem.title === "DiagnosticReportLab Summary Grouped by DiagnosticReport|Lab Code") {
             switch (columnData.title) {
               case "Diagnostic Report Name":
-                data["report"] = columnData.text?.div ?? "";
+                data["report"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
                 break;
               case "Performer":
-                data["performer"] = columnData.text?.div ?? "";
+                data["performer"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
                 break;
               case "Issued Date":
-                data["issued"] = columnData.text?.div ?? "";
+                data["issued"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
                 break;
               case "Status":
-                data["status"] = columnData.text?.div ?? "";
+                data["status"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
                 break;
               default:
                 break;
@@ -2425,8 +2767,8 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
                 observationhtml += `
                   <tr>
                     <td>${componentCode}</td>
-                    <td>${component["formattedValue"] ?? "-"}</td>
-                    <td>${component["referenceRange"]?.trim() ?? "-"}</td>
+                    <td>${templateUtilities.renderTextAsHtml(component["formattedValue"]) ?? "-"}</td>
+                    <td>${templateUtilities.renderTextAsHtml(component["referenceRange"])?.trim() ?? "-"}</td>
                     <td>${date ?? "-"}</td>
                   </tr>`;
               }
@@ -2439,8 +2781,8 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
               observationhtml += `
                   <tr>
                     <td>${data["code"] ?? "-"}</td>
-                    <td>${data["formattedValue"] ?? "-"}</td>
-                    <td>${data["referenceRange"]?.trim() ?? "-"}</td>
+                    <td>${templateUtilities.renderTextAsHtml(data["formattedValue"]) ?? "-"}</td>
+                    <td>${templateUtilities.renderTextAsHtml(data["referenceRange"])?.trim() ?? "-"}</td>
                     <td>${date ?? "-"}</td>
                   </tr>`;
             }
@@ -2491,30 +2833,80 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
     const observations = this.getObservations(resources);
     if (observations.length > 0) {
       observations.sort((a, b) => {
-        const dateA = a.effectiveDateTime || a.effectivePeriod?.start || 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;
+        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
@@ -2532,34 +2924,32 @@ 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) {
-      const obsCode = templateUtilities.codeableConcept(obs.code);
+      const obsCode = templateUtilities.renderTextAsHtml(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>`;
       }
@@ -2591,7 +2981,7 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
         <tbody>`;
     const diagnosticReportAdded = /* @__PURE__ */ new Set();
     for (const report of reports) {
-      const reportName = templateUtilities.codeableConcept(report.code);
+      const reportName = templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(report.code));
       if (!diagnosticReportAdded.has(reportName)) {
         diagnosticReportAdded.add(reportName);
         let resultCount = "";
@@ -2705,7 +3095,7 @@ var HistoryOfProceduresTemplate = class _HistoryOfProceduresTemplate {
       const proc = resourceItem;
       html += `
         <tr id="${templateUtilities.narrativeLinkId(proc)}">
-          <td>${templateUtilities.codeableConcept(proc.code, "display")}</td>
+          <td>${templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(proc.code, "display"))}</td>
           <td>${templateUtilities.renderNotes(proc.note, timezone)}</td>
           <td>${proc.performedDateTime ? templateUtilities.renderTime(proc.performedDateTime, timezone) : proc.performedPeriod ? templateUtilities.renderPeriod(proc.performedPeriod, timezone) : ""}</td>
         </tr>`;
@@ -2757,7 +3147,7 @@ var SocialHistoryTemplate = class _SocialHistoryTemplate {
     for (const obs of observations) {
       html += `
           <tr id="${templateUtilities.narrativeLinkId(obs)}">
-            <td>${templateUtilities.codeableConcept(obs.code)}</td>
+            <td>${templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(obs.code))}</td>
             <td>${templateUtilities.extractObservationValue(obs)}</td>
             <td>${templateUtilities.extractObservationValueUnit(obs)}</td>
             <td>${templateUtilities.renderNotes(obs.note, timezone)}</td>
@@ -2802,7 +3192,7 @@ var PastHistoryOfIllnessTemplate = class {
           <tbody>`;
     const addedConditionCodes = /* @__PURE__ */ new Set();
     for (const cond of resolvedConditions) {
-      const conditionCode = templateUtilities.codeableConcept(cond.code);
+      const conditionCode = templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(cond.code));
       if (!addedConditionCodes.has(conditionCode)) {
         addedConditionCodes.add(conditionCode);
         html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
@@ -2888,7 +3278,7 @@ var PlanOfCareTemplate = class {
         const data = {};
         for (const columnData of rowData.section ?? []) {
           if (columnData.title) {
-            data[columnData.title] = columnData.text?.div ?? "";
+            data[columnData.title] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
           }
         }
         if (data["status"] !== "active") {
@@ -2964,7 +3354,7 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
           <tbody>`;
       const addedConditionCodes = /* @__PURE__ */ new Set();
       for (const cond of activeConditions) {
-        const conditionCode = templateUtilities.codeableConcept(cond.code);
+        const conditionCode = templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(cond.code));
         if (!addedConditionCodes.has(conditionCode)) {
           addedConditionCodes.add(conditionCode);
           html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
@@ -3009,7 +3399,7 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
         if (impression.finding && impression.finding.length > 0) {
           findingsHtml = "<ul>";
           for (const finding of impression.finding) {
-            const findingText = finding.itemCodeableConcept ? templateUtilities.codeableConcept(finding.itemCodeableConcept) : finding.itemReference ? templateUtilities.renderReference(finding.itemReference) : "";
+            const findingText = finding.itemCodeableConcept ? templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(finding.itemCodeableConcept)) : finding.itemReference ? templateUtilities.renderReference(finding.itemReference) : "";
             const cause = finding.basis || "";
             findingsHtml += `<li>${findingText}${cause ? ` - ${cause}` : ""}</li>`;
           }
@@ -3070,9 +3460,9 @@ var PregnancyTemplate = class _PregnancyTemplate {
       const obs = resource;
       html += `
           <tr id="${templateUtilities.narrativeLinkId(obs)}">
-            <td>${templateUtilities.extractPregnancyStatus(obs)}</td>
+            <td>${templateUtilities.renderTextAsHtml(templateUtilities.extractPregnancyStatus(obs))}</td>
             <td>${templateUtilities.renderNotes(obs.note, timezone)}</td>
-            <td>${obs.effectiveDateTime ? templateUtilities.renderTime(obs.effectiveDateTime, timezone) : obs.effectivePeriod ? templateUtilities.renderPeriod(obs.effectivePeriod, timezone) : ""}</td>
+            <td>${obs.effectiveDateTime ? templateUtilities.renderTextAsHtml(templateUtilities.renderTime(obs.effectiveDateTime, timezone)) : obs.effectivePeriod ? templateUtilities.renderTextAsHtml(templateUtilities.renderPeriod(obs.effectivePeriod, timezone)) : ""}</td>
           </tr>`;
     }
     html += `
@@ -3122,7 +3512,7 @@ var AdvanceDirectivesTemplate = class _AdvanceDirectivesTemplate {
       const consent = resourceItem;
       html += `
         <tr id="${templateUtilities.narrativeLinkId(consent)}">
-          <td>${templateUtilities.codeableConcept(consent.scope, "display")}</td>
+          <td>${templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(consent.scope, "display"))}</td>
           <td>${consent.status || ""}</td>
           <td>${consent.provision?.action ? templateUtilities.concatCodeableConcept(consent.provision.action) : ""}</td>
           <td>${consent.dateTime || ""}</td>
@@ -3143,16 +3533,18 @@ var TypeScriptTemplateMapper = class {
    * @param resources - FHIR resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @param useSectionSummary - Whether to use the section summary for narrative generation
+   * @param now - Optional current date to use for generating relative dates in the narrative
    * @returns HTML string for rendering
    */
-  static generateNarrative(section, resources, timezone, useSectionSummary = false) {
+  static generateNarrative(section, resources, timezone, useSectionSummary = false, now) {
     const templateClass = this.sectionToTemplate[section];
     if (!templateClass) {
       throw new Error(`No template found for section: ${section}`);
     }
     return useSectionSummary ? templateClass.generateSummaryNarrative(
       resources,
-      timezone
+      timezone,
+      now
     ) : templateClass.generateNarrative(resources, timezone);
   }
 };
@@ -3210,14 +3602,15 @@ var NarrativeGenerator = class {
    * @param resources - Array of domain resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @param useSectionSummary - Whether to use section summary for narrative generation (default: false)
+   * @param now - Optional date parameter
    * @returns Generated HTML content or undefined if no resources
    */
-  static async generateNarrativeContentAsync(section, resources, timezone, useSectionSummary = false) {
+  static async generateNarrativeContentAsync(section, resources, timezone, useSectionSummary = false, now) {
     if (!resources || resources.length === 0) {
       return void 0;
     }
     try {
-      const content = TypeScriptTemplateMapper.generateNarrative(section, resources, timezone, useSectionSummary);
+      const content = TypeScriptTemplateMapper.generateNarrative(section, resources, timezone, useSectionSummary, now);
       if (!content) {
         return void 0;
       }
@@ -3239,8 +3632,8 @@ var NarrativeGenerator = class {
       const options = aggressive ? AGGRESSIVE_MINIFY_OPTIONS : DEFAULT_MINIFY_OPTIONS;
       return await htmlMinify(html, options);
     } catch (error) {
-      console.warn("HTML minification failed", error);
-      return html;
+      console.warn("HTML minification failed", error, html);
+      return `${error instanceof Error ? error.message : String(error)}`;
     }
   }
   /**
@@ -3269,10 +3662,11 @@ var NarrativeGenerator = class {
    * @param timezone - Optional timezone to use for date formatting
    * @param minify - Whether to minify the HTML content (default: true)
    * @param useSectionSummary - Whether to use section summary for narrative generation (default: false)
+   * @param now - Optional date parameter
    * @returns Promise that resolves to a FHIR Narrative object or undefined if no resources
    */
-  static async generateNarrativeAsync(section, resources, timezone, minify = true, useSectionSummary = false) {
-    const content = await this.generateNarrativeContentAsync(section, resources, timezone, useSectionSummary);
+  static async generateNarrativeAsync(section, resources, timezone, minify = true, useSectionSummary = false, now) {
+    const content = await this.generateNarrativeContentAsync(section, resources, timezone, useSectionSummary, now);
     if (!content) {
       return void 0;
     }
@@ -3449,8 +3843,9 @@ var ComprehensiveIPSCompositionBuilder = class {
    * @param baseUrl - Base URL for the FHIR server (e.g., 'https://example.com/fhir')
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @param patientId - Optional patient ID to use as primary patient for composition reference
+   * @param now - Optional current date to use for composition date (defaults to new Date())
    */
-  async buildBundleAsync(authorOrganizationId, authorOrganizationName, baseUrl, timezone, patientId) {
+  async buildBundleAsync(authorOrganizationId, authorOrganizationName, baseUrl, timezone, patientId, now) {
     if (baseUrl.endsWith("/")) {
       baseUrl = baseUrl.slice(0, -1);
     }
@@ -3477,20 +3872,22 @@ var ComprehensiveIPSCompositionBuilder = class {
         // Assuming patient is also a practitioner for simplicity
         display: authorOrganizationName
       }],
-      date: (/* @__PURE__ */ new Date()).toISOString(),
+      date: (now || /* @__PURE__ */ new Date()).toISOString(),
       title: "International Patient Summary",
       section: this.sections,
       text: await NarrativeGenerator.generateNarrativeAsync(
         "Patient" /* PATIENT */,
         this.patients,
         timezone,
-        true
+        true,
+        false,
+        now
       )
     };
     const bundle = {
       resourceType: "Bundle",
       type: "document",
-      timestamp: (/* @__PURE__ */ new Date()).toISOString(),
+      timestamp: (now || /* @__PURE__ */ new Date()).toISOString(),
       identifier: {
         "system": "urn:ietf:rfc:3986",
         "value": "urn:uuid:4dcfd353-49fd-4ab0-b521-c8d57ced74d6"