@imranq2/fhirpatientsummary 1.0.27 → 1.0.28

package/dist/index.cjs

@@ -248,7 +248,7 @@ 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 "";
   }
@@ -260,7 +260,7 @@ 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 "";
   }
@@ -299,7 +299,7 @@ var TemplateUtilities = class {
    */
   renderMedicationCode(medication) {
     if (medication && medication.code) {
-      return this.codeableConcept(medication.code, "display");
+      return this.renderTextAsHtml(this.codeableConcept(medication.code, "display"));
     }
     return "";
   }
@@ -310,7 +310,7 @@ var TemplateUtilities = class {
    */
   renderDoseNumber(doseNumber) {
     if (doseNumber && doseNumber.value !== void 0) {
-      return doseNumber.value.toString();
+      return this.renderTextAsHtml(doseNumber.value.toString());
     }
     return "";
   }
@@ -321,7 +321,7 @@ var TemplateUtilities = class {
    */
   renderValueUnit(value) {
     if (value && value.constructor?.name === "Quantity" && value.unit) {
-      return value.unit;
+      return this.renderTextAsHtml(value.unit);
     }
     return "";
   }
@@ -387,7 +387,7 @@ 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
@@ -404,7 +404,7 @@ var TemplateUtilities = class {
         items.push(item.text);
       }
     }
-    return items.join(", ");
+    return this.renderTextAsHtml(items.join(", "));
   }
   /**
    * Concatenates reaction manifestations
@@ -425,7 +425,7 @@ var TemplateUtilities = class {
         }
       }
     }
-    return texts.join(", ");
+    return this.renderTextAsHtml(texts.join(", "));
   }
   /**
    * Concatenates dose numbers
@@ -442,7 +442,7 @@ var TemplateUtilities = class {
         doseNumbers.push(item.doseNumberPositiveInt.toString());
       }
     }
-    return doseNumbers.join(", ");
+    return this.renderTextAsHtml(doseNumbers.join(", "));
   }
   /**
    * Concatenates dosage routes
@@ -459,7 +459,7 @@ 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
@@ -468,7 +468,7 @@ 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 "";
   }
@@ -487,7 +487,7 @@ var TemplateUtilities = class {
         texts.push(item.text);
       }
     }
-    return texts.join(", ");
+    return this.renderTextAsHtml(texts.join(", "));
   }
   /**
    * Renders component codes
@@ -819,9 +819,11 @@ 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() === "") {
@@ -885,7 +887,7 @@ var TemplateUtilities = class {
         dateTime = import_luxon.DateTime.fromISO(String(dateValue));
       }
       if (!dateTime.isValid) {
-        return String(dateValue);
+        return this.renderTextAsHtml(String(dateValue));
       }
       if (dateOnly) {
         dateTime = dateTime.toUTC();
@@ -901,9 +903,9 @@ 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));
     }
   }
   /**
@@ -1607,7 +1609,7 @@ 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);
@@ -1665,13 +1667,13 @@ 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;
@@ -1792,11 +1794,11 @@ 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 = "-";
@@ -1809,7 +1811,7 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
           }
         }
         html += `
-          <td class="ResolvedDate">${endDate}</td>`;
+          <td class="ResolvedDate">${templateUtilities.renderTextAsHtml(endDate)}</td>`;
       }
       html += `</tr>`;
     }
@@ -1832,17 +1834,21 @@ 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>
@@ -1856,40 +1862,48 @@ 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>${templateUtilities.renderTime(data["startDate"], timezone)}</td>
+                            </tr>`;
         }
       }
     }
@@ -2111,13 +2125,13 @@ var ImmunizationsTemplate = class _ImmunizationsTemplate {
         for (const columnData of rowData.section ?? []) {
           switch (columnData.title) {
             case "Immunization Name":
-              data["immunization"] = columnData.text?.div ?? "";
+              data["immunization"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
               break;
             case "Status":
-              data["status"] = columnData.text?.div ?? "";
+              data["status"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
               break;
             case "occurrenceDateTime":
-              data["occurrenceDateTime"] = columnData.text?.div ?? "";
+              data["occurrenceDateTime"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
               break;
             default:
               break;
@@ -2168,7 +2182,7 @@ var ImmunizationsTemplate = class _ImmunizationsTemplate {
         const imm = resourceItem;
         html += `
           <tr id="${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>${templateUtilities.renderVaccineManufacturer(imm)}</td>
@@ -2224,7 +2238,7 @@ var ProblemListTemplate = class _ProblemListTemplate {
           <tbody>`;
     const addedConditionCodes = /* @__PURE__ */ new Set();
     for (const cond of activeConditions) {
-      const conditionCode = templateUtilities.codeableConcept(cond.code);
+      const conditionCode = templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(cond.code));
       if (!addedConditionCodes.has(conditionCode)) {
         addedConditionCodes.add(conditionCode);
         html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
@@ -2284,7 +2298,7 @@ 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(
@@ -2296,7 +2310,7 @@ var VitalSignsTemplate = class _VitalSignsTemplate {
                 data[dataKey] = vitalValue;
               }
             }
-            data[columnTitle] = columnData.text?.div ?? "";
+            data[columnTitle] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
           }
         }
         isSummaryCreated = true;
@@ -2346,7 +2360,7 @@ 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>
@@ -2400,10 +2414,10 @@ 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 += `
@@ -2539,149 +2553,150 @@ 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;
@@ -2734,28 +2749,28 @@ 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;
@@ -2780,8 +2795,8 @@ 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>`;
               }
@@ -2794,8 +2809,8 @@ 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>`;
             }
@@ -2955,7 +2970,7 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
         <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 += `
@@ -2994,7 +3009,7 @@ 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 = "";
@@ -3108,7 +3123,7 @@ 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>${proc.performedDateTime ? templateUtilities.renderTime(proc.performedDateTime, timezone) : proc.performedPeriod ? templateUtilities.renderPeriod(proc.performedPeriod, timezone) : ""}</td>
         </tr>`;
@@ -3160,7 +3175,7 @@ var SocialHistoryTemplate = class _SocialHistoryTemplate {
     for (const obs of observations) {
       html += `
           <tr id="${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>${templateUtilities.renderNotes(obs.note, timezone)}</td>
@@ -3205,7 +3220,7 @@ var PastHistoryOfIllnessTemplate = class {
           <tbody>`;
     const addedConditionCodes = /* @__PURE__ */ new Set();
     for (const cond of resolvedConditions) {
-      const conditionCode = templateUtilities.codeableConcept(cond.code);
+      const conditionCode = templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(cond.code));
       if (!addedConditionCodes.has(conditionCode)) {
         addedConditionCodes.add(conditionCode);
         html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
@@ -3291,7 +3306,7 @@ 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") {
@@ -3367,7 +3382,7 @@ 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="${templateUtilities.narrativeLinkId(cond)}">
@@ -3412,7 +3427,7 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
         if (impression.finding && impression.finding.length > 0) {
           findingsHtml = "<ul>";
           for (const finding of impression.finding) {
-            const findingText = finding.itemCodeableConcept ? templateUtilities.codeableConcept(finding.itemCodeableConcept) : finding.itemReference ? templateUtilities.renderReference(finding.itemReference) : "";
+            const findingText = finding.itemCodeableConcept ? templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(finding.itemCodeableConcept)) : finding.itemReference ? templateUtilities.renderReference(finding.itemReference) : "";
             const cause = finding.basis || "";
             findingsHtml += `<li>${findingText}${cause ? ` - ${cause}` : ""}</li>`;
           }
@@ -3473,9 +3488,9 @@ var PregnancyTemplate = class _PregnancyTemplate {
       const obs = resource;
       html += `
           <tr id="${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>${obs.effectiveDateTime ? templateUtilities.renderTextAsHtml(templateUtilities.renderTime(obs.effectiveDateTime, timezone)) : obs.effectivePeriod ? templateUtilities.renderTextAsHtml(templateUtilities.renderPeriod(obs.effectivePeriod, timezone)) : ""}</td>
           </tr>`;
     }
     html += `
@@ -3525,7 +3540,7 @@ var AdvanceDirectivesTemplate = class _AdvanceDirectivesTemplate {
       const consent = resourceItem;
       html += `
         <tr id="${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>
@@ -3546,16 +3561,18 @@ 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: ${section}`);
     }
     return useSectionSummary ? templateClass.generateSummaryNarrative(
       resources,
-      timezone
+      timezone,
+      now
     ) : templateClass.generateNarrative(resources, timezone);
   }
 };
@@ -3613,14 +3630,15 @@ var NarrativeGenerator = class {
    * @param resources - Array of domain resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @param useSectionSummary - Whether to use section summary for narrative generation (default: false)
+   * @param now - Optional date parameter
    * @returns Generated HTML content or undefined if no resources
    */
-  static async generateNarrativeContentAsync(section, resources, timezone, useSectionSummary = false) {
+  static async generateNarrativeContentAsync(section, resources, timezone, useSectionSummary = false, now) {
     if (!resources || resources.length === 0) {
       return void 0;
     }
     try {
-      const content = TypeScriptTemplateMapper.generateNarrative(section, resources, timezone, useSectionSummary);
+      const content = TypeScriptTemplateMapper.generateNarrative(section, resources, timezone, useSectionSummary, now);
       if (!content) {
         return void 0;
       }
@@ -3642,8 +3660,8 @@ var NarrativeGenerator = class {
       const options = aggressive ? AGGRESSIVE_MINIFY_OPTIONS : DEFAULT_MINIFY_OPTIONS;
       return await (0, import_html_minifier_terser.minify)(html, options);
     } catch (error) {
-      console.warn("HTML minification failed", error);
-      return html;
+      console.warn("HTML minification failed", error, html);
+      return `${error instanceof Error ? error.message : String(error)}`;
     }
   }
   /**
@@ -3672,10 +3690,11 @@ 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;
     }
@@ -3852,8 +3871,9 @@ 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);
     }
@@ -3880,20 +3900,22 @@ 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"