@imranq2/fhirpatientsummary 1.0.28 → 1.0.30

package/dist/index.cjs

@@ -99,6 +99,13 @@ var PREGNANCY_LOINC_CODES = {
     "33065-4": "Ectopic Pregnancy"
   }
 };
+var PREGNANCY_SNOMED_CODES = [
+  // Add SNOMED CT codes for pregnancy history here, e.g.:
+  "72892002",
+  // Pregnancy (finding)
+  "77386006"
+  // History of pregnancy (situation)
+];
 var SOCIAL_HISTORY_LOINC_CODES = {
   "72166-2": "Tobacco Use",
   "74013-4": "Alcohol Use"
@@ -108,6 +115,29 @@ var BLOOD_PRESSURE_LOINC_CODES = {
   SYSTOLIC: "8480-6",
   DIASTOLIC: "8462-4"
 };
+var ESSENTIAL_LAB_PANELS = {
+  // Top 20 Most Ordered Panels
+  "24323-8": "Comprehensive Metabolic Panel (CMP)",
+  "24320-4": "Basic Metabolic Panel (BMP)",
+  "58410-2": "Complete Blood Count (CBC)",
+  "57021-8": "CBC with Differential",
+  "24331-1": "Lipid Panel",
+  "57698-3": "Lipid Panel with Direct LDL",
+  "24325-3": "Hepatic Function Panel",
+  "24362-6": "Renal Function Panel",
+  "24326-1": "Electrolyte Panel",
+  "24348-5": "Thyroid Panel",
+  "24356-8": "Urinalysis Complete",
+  "24352-7": "Iron Studies Panel",
+  "34714-6": "Coagulation Panel",
+  "24364-2": "Prenatal Panel",
+  "24108-3": "Acute Hepatitis Panel",
+  "24110-9": "Hepatitis B Panel",
+  "34574-4": "Arthritis Panel",
+  "24360-0": "Anemia Panel",
+  "80235-8": "Cardiac Markers Panel",
+  "69738-3": "CBC with Auto Differential"
+};
 
 // src/structures/ips_section_constants.ts
 var VITAL_SIGNS_SUMMARY_COMPONENT_MAP = {
@@ -132,34 +162,42 @@ var IPSSectionResourceFilters = {
   // Only include completed immunizations
   ["ImmunizationSection" /* IMMUNIZATIONS */]: (resource) => resource.resourceType === "Immunization" && resource.status === "completed" || resource.resourceType === "Organization",
   // Only include vital sign Observations (category.coding contains 'vital-signs')
-  ["VitalSignsSection" /* VITAL_SIGNS */]: (resource) => resource.resourceType === "Observation" && resource.category?.some((cat) => cat.coding?.some((c) => c.code === "vital-signs")),
+  ["VitalSignsSection" /* VITAL_SIGNS */]: (resource) => resource.resourceType === "Observation" && resource.category?.some((cat) => cat.coding?.some((c) => codingMatches(c, "vital-signs", c.system))),
   // 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) => resource.resourceType === "Observation" && resource.category?.some((cat) => cat.coding?.some((c) => RESULT_SUMMARY_OBSERVATION_CATEGORIES.includes(c.code))),
+  // Only include finalized diagnostic reports and relevant observations
+  ["ResultsSection" /* DIAGNOSTIC_REPORTS */]: (resource) => resource.resourceType === "DiagnosticReport" && resource.status === "final" || resource.resourceType === "Observation" && resource.category?.some((cat) => cat.coding?.some((c) => codingMatches(c, RESULT_SUMMARY_OBSERVATION_CATEGORIES, c.system))),
   // Only include completed procedures
   ["HistoryOfProceduresSection" /* PROCEDURES */]: (resource) => resource.resourceType === "Procedure" && resource.status === "completed",
   // Only include social history Observations
-  ["SocialHistorySection" /* SOCIAL_HISTORY */]: (resource) => resource.resourceType === "Observation" && resource.code?.coding?.some((c) => Object.keys(SOCIAL_HISTORY_LOINC_CODES).includes(c.code)),
-  // Only include pregnancy history Observations
-  ["HistoryOfPregnancySection" /* PREGNANCY_HISTORY */]: (resource) => resource.resourceType === "Observation" && (resource.code?.coding?.some((c) => Object.keys(PREGNANCY_LOINC_CODES.PREGNANCY_STATUS).includes(c.code)) || resource.valueCodeableConcept?.coding?.some((c) => Object.keys(PREGNANCY_LOINC_CODES.PREGNANCY_OUTCOME).includes(c.code))),
-  // Only include Conditions or completed ClinicalImpressions
-  ["FunctionalStatusSection" /* FUNCTIONAL_STATUS */]: (resource) => resource.resourceType === "Condition" && resource.clinicalStatus?.coding?.some((c) => !["inactive", "resolved"].includes(c.code)) || resource.resourceType === "ClinicalImpression" && resource.status === "completed",
+  ["SocialHistorySection" /* SOCIAL_HISTORY */]: (resource) => resource.resourceType === "Observation" && codeableConceptMatches(resource.code, Object.keys(SOCIAL_HISTORY_LOINC_CODES), "http://loinc.org"),
+  // Only include pregnancy history Observations or relevant Conditions
+  ["HistoryOfPregnancySection" /* PREGNANCY_HISTORY */]: (resource) => resource.resourceType === "Observation" && (codeableConceptMatches(resource.code, Object.keys(PREGNANCY_LOINC_CODES.PREGNANCY_STATUS), "http://loinc.org") || codeableConceptMatches(resource.valueCodeableConcept, Object.keys(PREGNANCY_LOINC_CODES.PREGNANCY_OUTCOME), "http://loinc.org") || codingMatches(resource.code?.coding?.[0], PREGNANCY_SNOMED_CODES, "http://snomed.info/sct") || codingMatches(resource.valueCodeableConcept?.coding?.[0], PREGNANCY_SNOMED_CODES, "http://snomed.info/sct")) || resource.resourceType === "Condition" && (codeableConceptMatches(resource.code, Object.keys(PREGNANCY_LOINC_CODES.PREGNANCY_STATUS), "http://loinc.org") || codeableConceptMatches(resource.code, Object.keys(PREGNANCY_LOINC_CODES.PREGNANCY_OUTCOME), "http://loinc.org") || codingMatches(resource.code?.coding?.[0], PREGNANCY_SNOMED_CODES, "http://snomed.info/sct")),
+  // Only include Observations with LOINC 47420-5, category 'functional-status', or category display containing 'functional', and completed ClinicalImpressions
+  ["FunctionalStatusSection" /* FUNCTIONAL_STATUS */]: (resource) => resource.resourceType === "Observation" && (codeableConceptMatches(resource.code, "47420-5", "http://loinc.org") || resource.category?.some(
+    (cat) => cat.coding?.some(
+      (c) => c.code === "functional-status" && c.system === "http://terminology.hl7.org/CodeSystem/observation-category" || typeof c.display === "string" && c.display.toLowerCase().includes("functional")
+    )
+  )) || resource.resourceType === "ClinicalImpression" && resource.status === "completed",
   // Only include resolved medical history Conditions
   ["HistoryOfPastIllnessSection" /* MEDICAL_HISTORY */]: (resource) => resource.resourceType === "Condition" && resource.clinicalStatus?.coding?.some((c) => ["inactive", "resolved"].includes(c.code)),
   // Only include active care plans
   ["PlanOfCareSection" /* CARE_PLAN */]: (resource) => resource.resourceType === "CarePlan" && resource.status === "active",
   // Only include active advance directives (Consent resources)
-  ["AdvanceDirectivesSection" /* ADVANCE_DIRECTIVES */]: (resource) => resource.resourceType === "Consent" && resource.status === "active"
+  // TODO: disable this until we right logic to get these
+  ["AdvanceDirectivesSection" /* ADVANCE_DIRECTIVES */]: () => false
 };
 var IPSSectionSummaryCompositionFilter = {
-  ["AllergyIntoleranceSection" /* ALLERGIES */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => c.system === IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM && c.code === "allergy_summary_document"),
-  ["VitalSignsSection" /* VITAL_SIGNS */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => c.system === IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM && c.code === "vital_summary_document"),
-  ["PlanOfCareSection" /* CARE_PLAN */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => c.system === IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM && c.code === "careplan_summary_document"),
-  ["ImmunizationSection" /* IMMUNIZATIONS */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => c.system === IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM && c.code === "immunization_summary_document"),
-  ["MedicationSummarySection" /* MEDICATIONS */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => c.system === IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM && c.code === "medication_summary_document"),
+  ["AllergyIntoleranceSection" /* ALLERGIES */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => codingMatches(c, "allergy_summary_document", IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM)),
+  ["VitalSignsSection" /* VITAL_SIGNS */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => codingMatches(c, "vital_summary_document", IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM)),
+  ["PlanOfCareSection" /* CARE_PLAN */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => codingMatches(c, "careplan_summary_document", IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM)),
+  ["ImmunizationSection" /* IMMUNIZATIONS */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => codingMatches(c, "immunization_summary_document", IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM)),
+  ["MedicationSummarySection" /* MEDICATIONS */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => codingMatches(c, "medication_summary_document", IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM)),
   // [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")
+  ["HistoryOfProceduresSection" /* PROCEDURES */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => codingMatches(c, "procedure_summary_document", IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM))
+};
+var IPSSectionSummaryIPSCompositionFilter = {
+  ["VitalSignsSection" /* VITAL_SIGNS */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => c.system === IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM && c.code === "ips_vital_summary_document")
 };
 var IPSSectionResourceHelper = class {
   static getResourceFilterForSection(section) {
@@ -173,10 +211,50 @@ var IPSSectionResourceHelper = class {
   static getSummaryCompositionFilterForSection(section) {
     return IPSSectionSummaryCompositionFilter[section];
   }
+  static getSummaryIPSCompositionFilterForSection(section) {
+    return IPSSectionSummaryIPSCompositionFilter[section];
+  }
 };
+function codingMatches(coding, code, system) {
+  if (!coding || !coding.system) return false;
+  if (Array.isArray(code)) {
+    return coding.system === system && code.includes(coding.code ?? "");
+  }
+  return coding.system === system && coding.code === code;
+}
+function codeableConceptMatches(codeableConcept, code, system) {
+  if (!codeableConcept || !Array.isArray(codeableConcept.coding)) return false;
+  return codeableConcept.coding.some((coding) => codingMatches(coding, code, system));
+}
 
 // src/narratives/templates/typescript/TemplateUtilities.ts
 var import_luxon = require("luxon");
+
+// src/structures/codingSystemDisplayNames.ts
+var CODING_SYSTEM_DISPLAY_NAMES = {
+  "http://snomed.info/sct": "SNOMED CT",
+  "http://loinc.org": "LOINC",
+  "http://hl7.org/fhir/sid/icd-10": "ICD-10",
+  "http://hl7.org/fhir/sid/icd-10-cm": "ICD-10-CM",
+  "http://hl7.org/fhir/sid/icd-9": "ICD-9",
+  "http://hl7.org/fhir/sid/cvx": "CVX",
+  "http://www.nlm.nih.gov/research/umls/rxnorm": "RxNorm",
+  "http://www.ama-assn.org/go/cpt": "CPT",
+  "http://unitsofmeasure.org": "UCUM",
+  "http://e-imo.com/products/problem-it": "IMO Problem IT",
+  "2.16.840.1.113883.6.285": "HCPCS Level II",
+  "https://fhir.cerner.com/4ff3b259-e48d-4066-8b35-a6a051f2802a/codeSet/72": "Cerner Code Set 72",
+  "http://hl7.org/fhir/sid/ndc": "NDC",
+  // Added mapping for NDC
+  "urn:oid:2.16.840.1.113883.12.292": "CVX",
+  "http://terminology.hl7.org/CodeSystem/data-absent-reason": "Data Absent Reason",
+  // Added mapping for Data Absent Reason
+  "2.16.840.1.113883.6.208": "NDDF"
+  // Add more as needed
+};
+var codingSystemDisplayNames_default = CODING_SYSTEM_DISPLAY_NAMES;
+
+// src/narratives/templates/typescript/TemplateUtilities.ts
 var TemplateUtilities = class {
   /**
    * Constructor to initialize the TemplateUtilities with a FHIR resources
@@ -186,47 +264,63 @@ var TemplateUtilities = class {
     this.resources = resources;
   }
   /**
-   * Formats a CodeableConcept object
-   * @param cc - The CodeableConcept object
-   * @param field - Optional specific field to return
-   * @returns Formatted string representation
+   * Returns the preferred coding from a list of codings.
+   * If a coding has an extension with url 'https://fhir.icanbwell.com/4_0_0/StructureDefinition/intelligence' and valueCode 'preferred', returns that coding.
+   * Otherwise, returns the first coding if it exists, else null.
+   * @param codings Array of coding objects
+   * @returns The preferred coding object or null
    */
-  codeableConcept(cc, field) {
-    if (!cc) {
-      return "";
+  getPreferredCoding(codings) {
+    if (!Array.isArray(codings) || codings.length === 0) return null;
+    for (const coding of codings) {
+      if (Array.isArray(coding.extension)) {
+        for (const ext of coding.extension) {
+          if (ext.url === "https://fhir.icanbwell.com/4_0_0/StructureDefinition/intelligence" && ext.valueCode === "preferred") {
+            return coding;
+          }
+        }
+      }
     }
+    return codings[0] || null;
+  }
+  /**
+   * Returns the display value from a CodeableConcept
+   * @param cc - The CodeableConcept object
+   * @param field - Optional specific field to extract (e.g., 'text', 'display', 'code')
+   * @returns Display string or empty string
+   */
+  codeableConceptDisplay(cc, field) {
+    if (!cc) return "";
     if (field) {
       if (cc[field]) {
         return cc[field];
-      } else if (cc.coding && cc.coding[0] && cc.coding[0][field]) {
-        return cc.coding[0][field];
+      } else if (cc.coding && cc.coding.length > 0) {
+        const preferredCoding = this.getPreferredCoding(cc.coding);
+        if (preferredCoding && preferredCoding[field]) {
+          return preferredCoding[field];
+        }
       }
     }
-    if (cc.text) {
-      return cc.text;
-    } else if (cc.coding && cc.coding[0]) {
-      if (cc.coding[0].display) {
-        return cc.coding[0].display;
-      } else if (cc.coding[0].code) {
-        return cc.coding[0].code;
-      }
+    if (cc.text) return cc.text;
+    if (cc.coding && cc.coding.length > 0) {
+      const preferredCoding = this.getPreferredCoding(cc.coding);
+      if (preferredCoding && preferredCoding.display) return preferredCoding.display;
     }
     return "";
   }
-  resolveReference(ref) {
-    if (!ref || !this.resources) {
-      return null;
-    }
-    const referenceParts = ref.reference?.split("/");
-    if (!referenceParts || referenceParts.length !== 2) {
-      return null;
-    }
-    const referenceResourceType = referenceParts[0];
-    const referenceResourceId = referenceParts[1];
-    const resource = this.resources.find((entry) => {
-      return entry.resourceType === referenceResourceType && entry.id === referenceResourceId;
-    });
-    return resource ? resource : null;
+  /**
+   * Returns the code and system from a CodeableConcept
+   * @param cc - The CodeableConcept object
+   * @returns Object with code and system, or empty strings if not present
+   */
+  codeableConceptCoding(cc) {
+    if (!cc || !cc.coding || !cc.coding.length) return "";
+    const preferredCoding = this.getPreferredCoding(cc.coding);
+    if (!preferredCoding) return "";
+    const code = preferredCoding.code || "";
+    const system = preferredCoding.system || "";
+    const systemDisplay = codingSystemDisplayNames_default[system] || system;
+    return code ? `${code} (${systemDisplay})` : "";
   }
   /**
    * Renders a Device reference
@@ -274,7 +368,7 @@ var TemplateUtilities = class {
       return "";
     }
     if (medicationType.medicationCodeableConcept) {
-      return this.codeableConcept(medicationType.medicationCodeableConcept);
+      return this.codeableConceptDisplay(medicationType.medicationCodeableConcept);
     } else if (medicationType.medicationReference) {
       return this.renderMedicationRef(medicationType.medicationReference);
     }
@@ -299,7 +393,7 @@ var TemplateUtilities = class {
    */
   renderMedicationCode(medication) {
     if (medication && medication.code) {
-      return this.renderTextAsHtml(this.codeableConcept(medication.code, "display"));
+      return this.renderTextAsHtml(this.codeableConceptDisplay(medication.code));
     }
     return "";
   }
@@ -468,7 +562,7 @@ var TemplateUtilities = class {
    */
   firstFromCodeableConceptList(list) {
     if (list && Array.isArray(list) && list[0]) {
-      return this.renderTextAsHtml(this.codeableConcept(list[0], "display"));
+      return this.renderTextAsHtml(this.codeableConceptDisplay(list[0]));
     }
     return "";
   }
@@ -808,16 +902,28 @@ var TemplateUtilities = class {
       return this.renderMedicationCode(medicationSource);
     }
     if (typeof medicationSource === "object" && ("coding" in medicationSource || "text" in medicationSource)) {
-      return this.codeableConcept(medicationSource);
+      return this.codeableConceptDisplay(medicationSource);
     }
     if (typeof medicationSource === "object" && "reference" in medicationSource) {
       const medication = this.resolveReference(medicationSource);
       if (medication && medication.code) {
-        return this.codeableConcept(medication.code);
+        return this.codeableConceptDisplay(medication.code);
       }
     }
     return "";
   }
+  /**
+   * Returns the owner tag from the resource meta.security array.
+   * @param resource - FHIR resource with meta tag
+   * @returns The owner code if found, otherwise undefined
+   */
+  getOwnerTag(resource) {
+    if (!resource?.meta?.security) return "";
+    const ownerEntry = resource.meta.security.find(
+      (sec) => sec.system === "https://www.icanbwell.com/owner" && !!sec.code
+    );
+    return ownerEntry?.code;
+  }
   /**
    * 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
@@ -981,6 +1087,21 @@ var TemplateUtilities = class {
     const denominatorUnit = valueRatio.denominator.unit ? ` ${valueRatio.denominator.unit}` : "";
     return `${numerator}${numeratorUnit} / ${denominator}${denominatorUnit}`;
   }
+  /**
+   * Finds the resource that matches the reference
+   * @param ref - Reference to a resource
+   * @returns The resource or null
+   */
+  resolveReference(ref) {
+    if (!ref || !this.resources) {
+      return null;
+    }
+    const refId = ref.reference?.split("/")[1];
+    const refType = ref.reference?.split("/")[0];
+    return this.resources.find(
+      (resource) => resource.resourceType === refType && resource.id === refId
+    ) || null;
+  }
 };
 
 // src/constants.ts
@@ -1609,7 +1730,7 @@ var PatientTemplate = class _PatientTemplate {
     const uniqueLanguages = /* @__PURE__ */ new Set();
     const preferredLanguages = /* @__PURE__ */ new Set();
     patient.communication.forEach((comm) => {
-      const language = templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(comm.language));
+      const language = templateUtilities.renderTextAsHtml(templateUtilities.codeableConceptDisplay(comm.language));
       if (language) {
         if (comm.preferred) {
           preferredLanguages.add(language);
@@ -1656,14 +1777,18 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
           <thead>
             <tr>
               <th>Allergen</th>
+              <th>Code (System)</th>
               <th>Criticality</th>
               <th>Recorded Date</th>
+              <th>Source</th>
             </tr>
           </thead>
           <tbody>`;
     for (const resourceItem of resources) {
       for (const rowData of resourceItem.section ?? []) {
+        const sectionCodeableConcept = rowData.code;
         const data = {};
+        data["codeSystem"] = templateUtilities.codeableConceptCoding(sectionCodeableConcept);
         for (const columnData of rowData.section ?? []) {
           switch (columnData.title) {
             case "Allergen Name":
@@ -1675,6 +1800,9 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
             case "Recorded Date":
               data["recordedDate"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
               break;
+            case "Source":
+              data["source"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
+              break;
             default:
               break;
           }
@@ -1682,9 +1810,11 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
         isSummaryCreated = true;
         html += `
             <tr>
-              <td>${data["allergen"] ?? "-"}</td>
-              <td>${data["criticality"] ?? "-"}</td>
-              <td>${templateUtilities.renderTime(data["recordedDate"], timezone) ?? "-"}</td>
+              <td>${data["allergen"] ?? ""}</td>
+               <td>${data["codeSystem"] ?? ""}</td>
+              <td>${data["criticality"] ?? ""}</td>
+              <td>${templateUtilities.renderTime(data["recordedDate"], timezone) ?? ""}</td>
+              <td>${data["source"] ?? ""}</td>
             </tr>`;
       }
     }
@@ -1732,10 +1862,12 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
             <tr>
               <th>Allergen</th>
               <th>Status</th>
+               <th>Code (System)</th>
               <th>Category</th>
               <th>Reaction</th>
               <th>Onset Date</th>
               <th>Comments</th>
+              <th>Source</th>
             </tr>
           </thead>
           <tbody>`;
@@ -1759,11 +1891,13 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
             <tr>
               <th>Allergen</th>
               <th>Status</th>
+              <th>Code (System)</th>
               <th>Category</th>
               <th>Reaction</th>
               <th>Onset Date</th>
               <th>Comments</th>
               <th>Resolved Date</th>
+              <th>Source</th>
             </tr>
           </thead>
           <tbody>`;
@@ -1794,14 +1928,16 @@ var AllergyIntoleranceTemplate = class _AllergyIntoleranceTemplate {
     for (const allergy of allergies) {
       html += `
         <tr id="${templateUtilities.narrativeLinkId(allergy.extension)}">
-          <td class="Name"><span class="AllergenName">${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">${templateUtilities.renderNotes(allergy.note, timezone, { styled: true, warning: true })}</td>`;
+          <td class="Name"><span class="AllergenName">${templateUtilities.renderTextAsHtml(templateUtilities.codeableConceptDisplay(allergy.code))}</span></td>
+          <td class="Status">${templateUtilities.renderTextAsHtml(templateUtilities.codeableConceptDisplay(allergy.clinicalStatus)) || ""}</td>
+          <td class="CodeSystem">${templateUtilities.codeableConceptCoding(allergy.code)}</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>
+           <td class="Source">${templateUtilities.getOwnerTag(allergy)}</td>`;
       if (includeResolved) {
-        let endDate = "-";
+        let endDate = "";
         if (allergy.extension && Array.isArray(allergy.extension)) {
           const endDateExt = allergy.extension.find(
             (ext) => ext.url === "http://hl7.org/fhir/StructureDefinition/allergyintolerance-resolutionDate"
@@ -1825,10 +1961,11 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
    * Generate HTML narrative for Medication resources
    * @param resources - FHIR Medication 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
    */
-  generateNarrative(resources, timezone) {
-    return _MedicationSummaryTemplate.generateStaticNarrative(resources, timezone);
+  generateNarrative(resources, timezone, now) {
+    return _MedicationSummaryTemplate.generateStaticNarrative(resources, timezone, now);
   }
   /**
    * Generate HTML narrative for Medication resources using summary
@@ -1841,23 +1978,27 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
     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());
+    const twoYearsAgo = new Date(currentDate.getFullYear(), currentDate.getMonth() - 24, currentDate.getDate());
     let html = `
         <div>
             <table>
             <thead>
                 <tr>
                 <th>Medication</th>
+                <th>Code (System)</th>
                 <th>Status</th>
                 <th>Sig</th>
                 <th>Days of Supply</th>
                 <th>Refills</th>
                 <th>Start Date</th>
+                <th>Source</th>
                 </tr>
             </thead>
             <tbody>`;
+    let skippedMedications = 0;
     for (const resourceItem of resources) {
       for (const rowData of resourceItem.section ?? []) {
+        const sectionCodeableConcept = rowData.code;
         const data = {};
         for (const columnData of rowData.section ?? []) {
           switch (columnData.title) {
@@ -1882,6 +2023,9 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
             case "Authored On Date":
               data["startDate"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
               break;
+            case "Source":
+              data["source"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
+              break;
             default:
               break;
           }
@@ -1893,16 +2037,21 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
             startDateObj = void 0;
           }
         }
-        if (data["status"] === "active" || startDateObj && startDateObj >= twelveMonthsAgo) {
+        if (!(data["status"] === "active" || startDateObj && startDateObj >= twoYearsAgo)) {
+          skippedMedications++;
+        }
+        if (data["status"] === "active" || startDateObj && startDateObj >= twoYearsAgo) {
           isSummaryCreated = true;
           html += `
                             <tr>
                                 <td>${templateUtilities.renderTextAsHtml(data["medication"])}</td>
+                                <td>${templateUtilities.codeableConceptCoding(sectionCodeableConcept)}</td>
                                 <td>${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>
+                                <td>${templateUtilities.renderTextAsHtml(data["source"])}</td>
                             </tr>`;
         }
       }
@@ -1911,7 +2060,14 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
             </tbody>
             </table>
         </div>`;
-    return isSummaryCreated ? html : void 0;
+    if (skippedMedications > 0) {
+      html += `
+<p><em>${skippedMedications} additional medications older than 2 years ago are present</em></p>`;
+    }
+    if (isSummaryCreated || skippedMedications > 0) {
+      return html;
+    }
+    return void 0;
   }
   /**
    * Safely parse a date string and return a valid Date object or null
@@ -1929,21 +2085,42 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
    * Internal static implementation that actually generates the narrative
    * @param resources - FHIR Medication 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
    */
-  // eslint-disable-next-line @typescript-eslint/no-unused-vars
-  static generateStaticNarrative(resources, timezone) {
+  static generateStaticNarrative(resources, timezone, now) {
     const templateUtilities = new TemplateUtilities(resources);
     let html = "";
     const medicationRequests = this.getMedicationRequests(templateUtilities, resources);
     const medicationStatements = this.getMedicationStatements(templateUtilities, resources);
     const allActiveMedications = [];
+    const currentDate = now || /* @__PURE__ */ new Date();
+    const twoYearsAgo = new Date(currentDate);
+    twoYearsAgo.setFullYear(currentDate.getFullYear() - 2);
+    let skippedMedications = 0;
+    const allMedications = [];
     medicationRequests.forEach((mr) => {
-      allActiveMedications.push({ type: "request", resource: mr.resource, extension: mr.extension });
+      allMedications.push({ type: "request", resource: mr.resource, extension: mr.extension });
     });
     medicationStatements.forEach((ms) => {
-      allActiveMedications.push({ type: "statement", resource: ms.resource, extension: ms.extension });
+      allMedications.push({ type: "statement", resource: ms.resource, extension: ms.extension });
     });
+    for (const med of allMedications) {
+      let dateString;
+      if (med.type === "request") {
+        const mr = med.resource;
+        dateString = mr.dispenseRequest?.validityPeriod?.start || mr.authoredOn;
+      } else {
+        const ms = med.resource;
+        dateString = ms.effectiveDateTime || ms.effectivePeriod?.start;
+      }
+      const dateObj = this.parseDate(dateString);
+      if (!dateObj || dateObj < twoYearsAgo) {
+        skippedMedications++;
+      } else {
+        allActiveMedications.push(med);
+      }
+    }
     const sortMedications = (medications) => {
       medications.sort((a, b) => {
         let dateStringA;
@@ -1974,7 +2151,14 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
       sortMedications(allActiveMedications);
       html += this.renderCombinedMedications(templateUtilities, allActiveMedications);
     }
-    return html;
+    if (skippedMedications > 0) {
+      html += `
+<p><em>${skippedMedications} additional medications older than 2 years ago are present</em></p>`;
+    }
+    if (allActiveMedications.length > 0 || skippedMedications > 0) {
+      return html;
+    }
+    return "";
   }
   /**
    * Extract MedicationRequest resources
@@ -2019,10 +2203,12 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
           <tr>
             <th>Type</th>
             <th>Medication</th>
+            <th>Code (System)</th>
             <th>Sig</th>
             <th>Dispense Quantity</th>
             <th>Refills</th>
             <th>Start Date</th>
+            <th>Source</th>
           </tr>
         </thead>
         <tbody>`;
@@ -2031,27 +2217,31 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
       let type;
       let medicationName;
       let sig;
-      let dispenseQuantity = "-";
-      let refills = "-";
-      let startDate = "-";
+      let dispenseQuantity = "";
+      let refills = "";
+      let startDate = "";
+      let codeSystemDisplay = "";
       if (medication.type === "request") {
         const mr = medication.resource;
         type = "Request";
         medicationName = templateUtilities.getMedicationName(
           mr.medicationReference || mr.medicationCodeableConcept
         );
-        sig = templateUtilities.concat(mr.dosageInstruction, "text") || "-";
+        sig = templateUtilities.concat(mr.dosageInstruction, "text") || "";
         if (mr.dispenseRequest?.quantity) {
           const quantity = mr.dispenseRequest.quantity;
           if (quantity.value) {
             dispenseQuantity = `${quantity.value} ${quantity.unit || quantity.code || ""}`.trim();
           }
         }
-        refills = mr.dispenseRequest?.numberOfRepeatsAllowed?.toString() || "-";
+        refills = mr.dispenseRequest?.numberOfRepeatsAllowed?.toString() || "";
         if (mr.dispenseRequest?.validityPeriod) {
-          startDate = mr.dispenseRequest.validityPeriod.start || "-";
+          startDate = mr.dispenseRequest.validityPeriod.start || "";
         } else {
-          startDate = mr.authoredOn || "-";
+          startDate = mr.authoredOn || "";
+        }
+        if (mr.medicationCodeableConcept && mr.medicationCodeableConcept.coding && mr.medicationCodeableConcept.coding[0]) {
+          codeSystemDisplay = templateUtilities.codeableConceptCoding(mr.medicationCodeableConcept);
         }
       } else {
         const ms = medication.resource;
@@ -2059,21 +2249,26 @@ var MedicationSummaryTemplate = class _MedicationSummaryTemplate {
         medicationName = templateUtilities.getMedicationName(
           ms.medicationReference || ms.medicationCodeableConcept
         );
-        sig = templateUtilities.concat(ms.dosage, "text") || "-";
+        sig = templateUtilities.concat(ms.dosage, "text") || "";
         if (ms.effectiveDateTime) {
           startDate = ms.effectiveDateTime;
         } else if (ms.effectivePeriod) {
-          startDate = ms.effectivePeriod.start || "-";
+          startDate = ms.effectivePeriod.start || "";
+        }
+        if (ms.medicationCodeableConcept && ms.medicationCodeableConcept.coding && ms.medicationCodeableConcept.coding[0]) {
+          codeSystemDisplay = templateUtilities.codeableConceptCoding(ms.medicationCodeableConcept);
         }
       }
       html += `
         <tr${narrativeLinkId ? ` id="${narrativeLinkId}"` : ""}>
           <td>${type}</td>
           <td>${medicationName}<ul></ul></td>
+          <td>${codeSystemDisplay}</td>
           <td>${sig}</td>
           <td>${dispenseQuantity}</td>
           <td>${refills}</td>
           <td>${startDate}</td>
+           <td>${templateUtilities.getOwnerTag(medication.resource)}</td>
         </tr>`;
     }
     html += `
@@ -2114,14 +2309,18 @@ var ImmunizationsTemplate = class _ImmunizationsTemplate {
           <thead>
             <tr>
               <th>Immunization</th>
+              <th>Code (System)</th>
               <th>Status</th>
               <th>Date</th>
+              <th>Source</th>
             </tr>
           </thead>
           <tbody>`;
     for (const resourceItem of resources) {
       for (const rowData of resourceItem.section ?? []) {
+        const sectionCodeableConcept = rowData.code;
         const data = {};
+        data["codeSystem"] = templateUtilities.codeableConceptCoding(sectionCodeableConcept);
         for (const columnData of rowData.section ?? []) {
           switch (columnData.title) {
             case "Immunization Name":
@@ -2133,6 +2332,9 @@ var ImmunizationsTemplate = class _ImmunizationsTemplate {
             case "occurrenceDateTime":
               data["occurrenceDateTime"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
               break;
+            case "Source":
+              data["source"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
+              break;
             default:
               break;
           }
@@ -2141,9 +2343,11 @@ var ImmunizationsTemplate = class _ImmunizationsTemplate {
           isSummaryCreated = true;
           html += `
               <tr>
-                <td>${data["immunization"] ?? "-"}</td>
-                <td>${data["status"] ?? "-"}</td>
-                <td>${templateUtilities.renderTime(data["occurrenceDateTime"], timezone) ?? "-"}</td>
+                <td>${data["immunization"] ?? ""}</td>
+                <td>${data["codeSystem"] ?? ""}</td>
+                <td>${data["status"] ?? ""}</td>
+                <td>${templateUtilities.renderTime(data["occurrenceDateTime"], timezone) ?? ""}</td>
+                <td>${data["source"] ?? ""}</td>
               </tr>`;
         }
       }
@@ -2167,12 +2371,14 @@ var ImmunizationsTemplate = class _ImmunizationsTemplate {
         <thead>
           <tr>
             <th>Immunization</th>
+            <th>Code (System)</th>
             <th>Status</th>
             <th>Dose Number</th>
             <th>Manufacturer</th>
             <th>Lot Number</th>
             <th>Comments</th>
             <th>Date</th>
+            <th>Source</th>
           </tr>
         </thead>
         <tbody>`;
@@ -2182,13 +2388,15 @@ var ImmunizationsTemplate = class _ImmunizationsTemplate {
         const imm = resourceItem;
         html += `
           <tr id="${templateUtilities.narrativeLinkId(imm)}">
-            <td>${templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(imm.vaccineCode))}</td>
+            <td>${templateUtilities.renderTextAsHtml(templateUtilities.codeableConceptDisplay(imm.vaccineCode))}</td>
+            <td>${templateUtilities.codeableConceptCoding(imm.vaccineCode)}</td>
             <td>${imm.status || ""}</td>
             <td>${templateUtilities.concatDoseNumber(imm.protocolApplied)}</td>
             <td>${templateUtilities.renderVaccineManufacturer(imm)}</td>
             <td>${imm.lotNumber || ""}</td>
             <td>${templateUtilities.renderNotes(imm.note, timezone)}</td>
             <td>${templateUtilities.renderTime(imm.occurrenceDateTime, timezone)}</td>
+            <td>${templateUtilities.getOwnerTag(imm)}</td>
           </tr>`;
       }
     }
@@ -2222,8 +2430,11 @@ var ProblemListTemplate = class _ProblemListTemplate {
     let html = ``;
     const activeConditions = resources.map((entry) => entry) || [];
     activeConditions.sort((a, b) => {
-      const dateA = a.recordedDate ? new Date(a.recordedDate).getTime() : 0;
-      const dateB = b.recordedDate ? new Date(b.recordedDate).getTime() : 0;
+      if (!a.recordedDate && b.recordedDate) return -1;
+      if (a.recordedDate && !b.recordedDate) return 1;
+      if (!a.recordedDate && !b.recordedDate) return 0;
+      const dateA = new Date(a.recordedDate).getTime();
+      const dateB = new Date(b.recordedDate).getTime();
       return dateB - dateA;
     });
     html += `
@@ -2231,22 +2442,28 @@ var ProblemListTemplate = class _ProblemListTemplate {
           <thead>
             <tr>
               <th>Problem</th>
+              <th>Code (System)</th>
               <th>Onset Date</th>
               <th>Recorded Date</th>
+              <th>Source</th>
             </tr>
           </thead>
           <tbody>`;
-    const addedConditionCodes = /* @__PURE__ */ new Set();
+    const seenCodeAndSystems = /* @__PURE__ */ new Set();
     for (const cond of activeConditions) {
-      const conditionCode = templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(cond.code));
-      if (!addedConditionCodes.has(conditionCode)) {
-        addedConditionCodes.add(conditionCode);
-        html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
-            <td class="Name">${conditionCode}</td>
-            <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
-            <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
-          </tr>`;
+      const conditionDisplay = templateUtilities.codeableConceptDisplay(cond.code);
+      const codeAndSystem = templateUtilities.codeableConceptCoding(cond.code);
+      if (codeAndSystem && seenCodeAndSystems.has(codeAndSystem)) {
+        continue;
       }
+      seenCodeAndSystems.add(codeAndSystem);
+      html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
+          <td class="Name">${conditionDisplay}</td>
+          <td class="CodeSystem">${codeAndSystem}</td>
+          <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
+          <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
+          <td class="Source">${templateUtilities.getOwnerTag(cond)}</td>
+        </tr>`;
     }
     html += `</tbody>
         </table>`;
@@ -2279,16 +2496,19 @@ var VitalSignsTemplate = class _VitalSignsTemplate {
         <table>
           <thead>
             <tr>
-              <th>Vital Name</th>
+              <th>Name</th>
+              <th>Code (System)</th>
               <th>Result</th>
-              <th>Reference Range</th>
               <th>Date</th>
+              <th>Source</th>
             </tr>
           </thead>
           <tbody>`;
     for (const resourceItem of resources) {
       for (const rowData of resourceItem.section ?? []) {
+        const sectionCodeableConcept = rowData.code;
         const data = {};
+        data["codeSystem"] = templateUtilities.codeableConceptCoding(sectionCodeableConcept);
         for (const columnData of rowData.section ?? []) {
           const columnTitle = columnData.title;
           if (columnTitle) {
@@ -2316,10 +2536,11 @@ var VitalSignsTemplate = class _VitalSignsTemplate {
         isSummaryCreated = true;
         html += `
           <tr>
-            <td>${data["Vital Name"] ?? "-"}</td>
-            <td>${templateUtilities.extractObservationSummaryValue(data, timezone) ?? "-"}</td>
-            <td>${templateUtilities.extractObservationSummaryReferenceRange(data) ?? "-"}</td>
-            <td>${templateUtilities.extractObservationSummaryEffectiveTime(data, timezone) ?? "-"}</td>
+            <td>${data["Vital Name"] ?? ""}</td>
+            <td>${data["codeSystem"] ?? ""}</td>
+            <td>${templateUtilities.extractObservationSummaryValue(data, timezone) ?? ""}</td>
+            <td>${templateUtilities.extractObservationSummaryEffectiveTime(data, timezone) ?? ""}</td>
+            <td>${data["Source"] ?? ""}</td>
           </tr>`;
       }
     }
@@ -2347,26 +2568,30 @@ var VitalSignsTemplate = class _VitalSignsTemplate {
       <table>
         <thead>
           <tr>
-            <th>Vital Name</th>
+            <th>Name</th>
+            <th>Code (System)</th>
             <th>Result</th>
             <th>Unit</th>
             <th>Interpretation</th>
             <th>Component(s)</th>
             <th>Comments</th>
             <th>Date</th>
+            <th>Source</th>
           </tr>
         </thead>
         <tbody>`;
     for (const obs of observations) {
       html += `
           <tr id="${templateUtilities.narrativeLinkId(obs)}">
-            <td>${templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(obs.code, "display"))}</td>
+            <td>${templateUtilities.renderTextAsHtml(templateUtilities.codeableConceptDisplay(obs.code, "display"))}</td>
+            <td>${templateUtilities.codeableConceptCoding(obs.code)}</td>
             <td>${templateUtilities.extractObservationValue(obs)}</td>
             <td>${templateUtilities.extractObservationValueUnit(obs)}</td>
             <td>${templateUtilities.firstFromCodeableConceptList(obs.interpretation)}</td>
             <td>${templateUtilities.renderComponent(obs.component)}</td>
             <td>${templateUtilities.renderNotes(obs.note, timezone)}</td>
             <td>${obs.effectiveDateTime ? templateUtilities.renderTime(obs.effectiveDateTime, timezone) : obs.effectivePeriod ? templateUtilities.renderPeriod(obs.effectivePeriod, timezone) : ""}</td>
+            <td>${templateUtilities.getOwnerTag(obs)}</td>
           </tr>`;
     }
     html += `
@@ -2439,10 +2664,11 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
    * Generate HTML narrative for Diagnostic Results
    * @param resources - FHIR resources array containing Observation and DiagnosticReport resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
+   * @param now - Optional current date for filtering
    * @returns HTML string for rendering
    */
-  generateNarrative(resources, timezone) {
-    return _DiagnosticResultsTemplate.generateStaticNarrative(resources, timezone);
+  generateNarrative(resources, timezone, now) {
+    return _DiagnosticResultsTemplate.generateStaticNarrative(resources, timezone, now);
   }
   /**
    * Helper function to format observation data fields
@@ -2655,6 +2881,7 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
         break;
       case "valueRange.high.value":
         targetData["valueRangeHighValue"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
+        targetData["valueType"] = "valueRange";
         break;
       case "valueRange.high.unit":
         targetData["valueRangeHighUnit"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
@@ -2669,6 +2896,7 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
         break;
       case "valueRatio.denominator.value":
         targetData["valueRatioDenominatorValue"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
+        targetData["valueType"] = "valueRatio";
         break;
       case "valueRatio.denominator.unit":
         targetData["valueRatioDenominatorUnit"] = templateUtilities.renderTextAsHtml(column.text?.div ?? "");
@@ -2706,10 +2934,71 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
    * Generate HTML narrative for Diagnostic Results & Observation resources using summary
    * @param resources - FHIR Composition resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
+   * @param now - Optional current date for filtering
    * @returns HTML string for rendering
    */
-  generateSummaryNarrative(resources, timezone) {
+  generateSummaryNarrative(resources, timezone, now) {
     const templateUtilities = new TemplateUtilities(resources);
+    const currentDate = now || /* @__PURE__ */ new Date();
+    const twoYearsAgo = new Date(currentDate);
+    twoYearsAgo.setFullYear(currentDate.getFullYear() - 2);
+    let skippedObservations = 0;
+    let skippedDiagnosticReports = 0;
+    for (const resourceItem of resources) {
+      for (const rowData of resourceItem.section ?? []) {
+        if (resourceItem.title === "Observation|Labs Summary Grouped by Lab Code") {
+          for (const columnData of rowData.section ?? []) {
+            if (columnData.text?.div === "Observation.component" && columnData.section) {
+              for (const componentSection of columnData.section) {
+                const componentData = {};
+                for (const nestedColumn of componentSection.section ?? []) {
+                  this.extractSummaryObservationFields(nestedColumn, componentData, templateUtilities);
+                }
+                let compDate = void 0;
+                if (componentData["effectiveDateTime"]) {
+                  compDate = new Date(componentData["effectiveDateTime"]);
+                } else if (componentData["effectivePeriodStart"]) {
+                  compDate = new Date(componentData["effectivePeriodStart"]);
+                }
+                if (compDate && compDate < twoYearsAgo) {
+                  skippedObservations++;
+                }
+              }
+            } else {
+              const data = {};
+              this.extractSummaryObservationFields(columnData, data, templateUtilities);
+              let obsDate = void 0;
+              if (data["effectiveDateTime"]) {
+                obsDate = new Date(data["effectiveDateTime"]);
+              } else if (data["effectivePeriodStart"]) {
+                obsDate = new Date(data["effectivePeriodStart"]);
+              }
+              if (obsDate && obsDate < twoYearsAgo) {
+                skippedObservations++;
+              }
+            }
+          }
+        } else if (resourceItem.title === "DiagnosticReportLab Summary Grouped by DiagnosticReport|Lab Code") {
+          let issuedDate = void 0;
+          let status = void 0;
+          let reportFound = false;
+          for (const columnData of rowData.section ?? []) {
+            if (columnData.title === "Issued Date") {
+              issuedDate = columnData.text?.div ? new Date(columnData.text.div) : void 0;
+            }
+            if (columnData.title === "Status") {
+              status = columnData.text?.div;
+            }
+            if (columnData.title === "Diagnostic Report Name") {
+              reportFound = true;
+            }
+          }
+          if (status === "final" && issuedDate && issuedDate < twoYearsAgo && reportFound) {
+            skippedDiagnosticReports++;
+          }
+        }
+      }
+    }
     let html = `
       <div>`;
     let observationhtml = `
@@ -2718,10 +3007,12 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
         <table>
           <thead>
             <tr>
-              <th>Code</th>
+              <th>Name</th>
+              <th>Code (System)</th>
               <th>Result</th>
               <th>Reference Range</th>
               <th>Date</th>
+              <th>Source</th>
             </tr>
           </thead>
           <tbody>`;
@@ -2734,6 +3025,7 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
               <th>Report</th>
               <th>Performer</th>
               <th>Issued</th>
+              <th>Source</th>
             </tr>
           </thead>
           <tbody>`;
@@ -2741,7 +3033,9 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
     const diagnosticReportAdded = /* @__PURE__ */ new Set();
     for (const resourceItem of resources) {
       for (const rowData of resourceItem.section ?? []) {
+        const sectionCodeableConcept = rowData.code;
         const data = {};
+        data["codeSystem"] = templateUtilities.codeableConceptCoding(sectionCodeableConcept);
         const components = [];
         for (const columnData of rowData.section ?? []) {
           if (resourceItem.title === "Observation|Labs Summary Grouped by Lab Code") {
@@ -2751,7 +3045,13 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
                 for (const nestedColumn of componentSection.section ?? []) {
                   this.extractSummaryObservationFields(nestedColumn, componentData, templateUtilities);
                 }
-                if (Object.keys(componentData).length > 0) {
+                let compDate = void 0;
+                if (componentData["effectiveDateTime"]) {
+                  compDate = new Date(componentData["effectiveDateTime"]);
+                } else if (componentData["effectivePeriodStart"]) {
+                  compDate = new Date(componentData["effectivePeriodStart"]);
+                }
+                if (compDate && compDate >= twoYearsAgo && Object.keys(componentData).length > 0) {
                   components.push(componentData);
                 }
               }
@@ -2772,6 +3072,9 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
               case "Status":
                 data["status"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
                 break;
+              case "Source":
+                data["source"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
+                break;
               default:
                 break;
             }
@@ -2779,6 +3082,12 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
         }
         if (resourceItem.title === "Observation|Labs Summary Grouped by Lab Code") {
           let date = data["effectiveDateTime"] ? templateUtilities.renderTime(data["effectiveDateTime"], timezone) : "";
+          let obsDate = void 0;
+          if (data["effectiveDateTime"]) {
+            obsDate = new Date(data["effectiveDateTime"]);
+          } else if (data["effectivePeriodStart"]) {
+            obsDate = new Date(data["effectivePeriodStart"]);
+          }
           if (!date && data["effectivePeriodStart"]) {
             date = templateUtilities.renderTime(data["effectivePeriodStart"], timezone);
             if (data["effectivePeriodEnd"]) {
@@ -2795,36 +3104,47 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
                 observationhtml += `
                   <tr>
                     <td>${componentCode}</td>
-                    <td>${templateUtilities.renderTextAsHtml(component["formattedValue"]) ?? "-"}</td>
-                    <td>${templateUtilities.renderTextAsHtml(component["referenceRange"])?.trim() ?? "-"}</td>
-                    <td>${date ?? "-"}</td>
+                    <td></td>
+                    <td>${templateUtilities.renderTextAsHtml(component["formattedValue"]) ?? ""}</td>
+                    <td>${templateUtilities.renderTextAsHtml(component["referenceRange"])?.trim() ?? ""}</td>
+                    <td>${date ?? ""}</td>
+                    <td>${data["source"] ?? ""}</td>
                   </tr>`;
               }
             }
           } else {
-            const code = data["code"] ?? "";
-            if (code && !observationAdded.has(code)) {
-              observationAdded.add(code);
-              this.formatSummaryObservationData(data);
-              observationhtml += `
+            if (obsDate && obsDate >= twoYearsAgo) {
+              const code = data["code"] ?? "";
+              if (code && !observationAdded.has(code)) {
+                observationAdded.add(code);
+                this.formatSummaryObservationData(data);
+                observationhtml += `
                   <tr>
-                    <td>${data["code"] ?? "-"}</td>
-                    <td>${templateUtilities.renderTextAsHtml(data["formattedValue"]) ?? "-"}</td>
-                    <td>${templateUtilities.renderTextAsHtml(data["referenceRange"])?.trim() ?? "-"}</td>
-                    <td>${date ?? "-"}</td>
+                    <td>${data["code"] ?? ""}</td>
+                    <td>${templateUtilities.codeableConceptCoding(sectionCodeableConcept)}</td>
+                    <td>${templateUtilities.renderTextAsHtml(data["formattedValue"]) ?? ""}</td>
+                    <td>${templateUtilities.renderTextAsHtml(data["referenceRange"])?.trim() ?? ""}</td>
+                    <td>${date ?? ""}</td>
+                    <td>${data["source"] ?? ""}</td>
                   </tr>`;
+              }
             }
           }
         } else if (resourceItem.title === "DiagnosticReportLab Summary Grouped by DiagnosticReport|Lab Code") {
-          if (data["status"] === "final") {
+          let issuedDate = void 0;
+          if (data["issued"]) {
+            issuedDate = new Date(data["issued"]);
+          }
+          if (data["status"] === "final" && issuedDate && issuedDate >= twoYearsAgo) {
             const reportName = data["report"] ?? "";
             if (reportName && !diagnosticReportAdded.has(reportName)) {
               diagnosticReportAdded.add(reportName);
               diagnosticReporthtml += `
                     <tr>
-                      <td>${data["report"] ?? "-"}</td>
-                      <td>${data["performer"] ?? "-"}</td>
-                      <td>${templateUtilities.renderTime(data["issued"], timezone) ?? "-"}</td>
+                      <td>${data["report"] ?? ""}</td>
+                      <td>${data["performer"] ?? ""}</td>
+                      <td>${templateUtilities.renderTime(data["issued"], timezone) ?? ""}</td>
+                        <td>${data["source"] ?? ""}</td>
                     </tr>`;
             }
           }
@@ -2837,6 +3157,10 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
             </tbody>
           </table>
           </div>`;
+      if (skippedObservations > 0) {
+        html += `
+<p><em>${skippedObservations} additional observations older than 2 years ago are present</em></p>`;
+      }
     }
     if (diagnosticReportAdded.size > 0) {
       html += diagnosticReporthtml;
@@ -2844,6 +3168,10 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
             </tbody>
           </table>
           </div>`;
+      if (skippedDiagnosticReports > 0) {
+        html += `
+<p><em>${skippedDiagnosticReports} additional diagnostic reports older than 2 years ago are present</em></p>`;
+      }
     }
     html += `
       </div>`;
@@ -2853,12 +3181,32 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
    * Internal static implementation that actually generates the narrative
    * @param resources - FHIR resources array containing Observation and DiagnosticReport resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
+   * @param now - Optional current date for filtering
    * @returns HTML string for rendering
    */
-  static generateStaticNarrative(resources, timezone) {
+  static generateStaticNarrative(resources, timezone, now) {
     const templateUtilities = new TemplateUtilities(resources);
+    const currentDate = now || /* @__PURE__ */ new Date();
+    const twoYearsAgo = new Date(currentDate);
+    twoYearsAgo.setFullYear(currentDate.getFullYear() - 2);
     let html = "";
-    const observations = this.getObservations(resources);
+    let skippedObservations = 0;
+    let skippedDiagnosticReports = 0;
+    for (const resourceItem of resources) {
+      if (resourceItem.resourceType === "Observation") {
+        const obsDate = this.getObservationDate(resourceItem);
+        if (obsDate && obsDate < twoYearsAgo) {
+          skippedObservations++;
+        }
+      } else if (resourceItem.resourceType === "DiagnosticReport") {
+        const issued = resourceItem.issued;
+        const status = resourceItem.status;
+        if (status === "final" && issued && new Date(issued) < twoYearsAgo) {
+          skippedDiagnosticReports++;
+        }
+      }
+    }
+    const observations = this.getObservations(resources, twoYearsAgo);
     if (observations.length > 0) {
       observations.sort((a, b) => {
         const dateA = this.getObservationDate(a);
@@ -2867,16 +3215,22 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
       });
       this.filterObservationForLoincCodes(observations);
       html += this.renderObservations(templateUtilities, observations, timezone);
+      if (skippedObservations > 0) {
+        html += `
+<p><em>${skippedObservations} additional observations older than 2 years ago are present</em></p>`;
+      }
     }
-    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);
+    const diagnosticReports = this.getDiagnosticReports(resources, twoYearsAgo).filter((resource) => !this.isPanelDiagnosticReport(resource));
+    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 (skippedDiagnosticReports > 0) {
+        html += `
+<p><em>${skippedDiagnosticReports} additional diagnostic reports older than 2 years ago are present</em></p>`;
       }
     }
     return html;
@@ -2921,15 +3275,16 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
     return obsDate;
   }
   /**
-  * Get all Observation resources from the resource array
-  * @param resources - FHIR resources array
-  * @returns Array of Observation resources
-  */
-  static getObservations(resources) {
+   * Get all Observation resources from the resource array, filtered by twoYearsAgo
+   * @param resources - FHIR resources array
+   * @param twoYearsAgo - Date object representing the cutoff
+   * @returns Array of Observation resources
+   */
+  static getObservations(resources, twoYearsAgo) {
     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)) {
+        if (obsDate && obsDate >= twoYearsAgo) {
           return true;
         }
       }
@@ -2937,12 +3292,21 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
     }).map((resourceItem) => resourceItem);
   }
   /**
-   * Get all DiagnosticReport resources from the resource array
+   * Get all DiagnosticReport resources from the resource array, filtered by twoYearsAgo
    * @param resources - FHIR resources array
+   * @param twoYearsAgo - Date object representing the cutoff
    * @returns Array of DiagnosticReport resources
    */
-  static getDiagnosticReports(resources) {
-    return resources.filter((resourceItem) => resourceItem.resourceType === "DiagnosticReport").map((resourceItem) => resourceItem);
+  static getDiagnosticReports(resources, twoYearsAgo) {
+    return resources.filter((resourceItem) => {
+      if (resourceItem.resourceType === "DiagnosticReport") {
+        const issued = resourceItem.issued;
+        if (issued && new Date(issued) >= twoYearsAgo) {
+          return true;
+        }
+      }
+      return false;
+    }).map((resourceItem) => resourceItem);
   }
   /**
    * Render HTML table for Observation resources
@@ -2953,32 +3317,36 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
    */
   static renderObservations(templateUtilities, observations, timezone) {
     let html = "";
-    if (process.env.ENABLE_DIAGNOSTIC_REPORTS_IN_SUMMARY === "true") {
-      html += `
-      <h3>Observations</h3>`;
-    }
+    html += `
+    <h3>Observations</h3>`;
     html += `
       <table>
         <thead>
           <tr>
-            <th>Code</th>
+            <th>Name</th>
+            <th>Code (System)</th>
             <th>Result</th>
             <th>Reference Range</th>
             <th>Date</th>
+            <th>Source</th>
           </tr>
         </thead>
         <tbody>`;
     const observationAdded = /* @__PURE__ */ new Set();
     for (const obs of observations) {
-      const obsCode = templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(obs.code));
-      if (!observationAdded.has(obsCode)) {
-        observationAdded.add(obsCode);
+      const obsCodeDisplay = templateUtilities.renderTextAsHtml(templateUtilities.codeableConceptDisplay(obs.code));
+      const obsCodeAndSystem = templateUtilities.codeableConceptCoding(obs.code);
+      if (!observationAdded.has(obsCodeDisplay) && !observationAdded.has(obsCodeAndSystem)) {
+        observationAdded.add(obsCodeDisplay);
+        observationAdded.add(obsCodeAndSystem);
         html += `
           <tr id="${templateUtilities.narrativeLinkId(obs)}">
-            <td>${obsCode}</td>
+            <td>${obsCodeDisplay}</td>
+            <td>${templateUtilities.codeableConceptCoding(obs.code)}</td>
             <td>${templateUtilities.extractObservationValue(obs)}</td>
             <td>${templateUtilities.concatReferenceRange(obs.referenceRange)}</td>
             <td>${obs.effectiveDateTime ? templateUtilities.renderTime(obs.effectiveDateTime, timezone) : obs.effectivePeriod ? templateUtilities.renderPeriod(obs.effectivePeriod, timezone) : ""}</td>
+            <td>${templateUtilities.getOwnerTag(obs)}</td>
           </tr>`;
       }
     }
@@ -3001,17 +3369,21 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
         <thead>
           <tr>
             <th>Report</th>
+            <th>Code (System)</th>
             <th>Category</th>
             <th>Result</th>
             <th>Issued</th>
+            <th>Source</th>
           </tr>
         </thead>
         <tbody>`;
     const diagnosticReportAdded = /* @__PURE__ */ new Set();
     for (const report of reports) {
-      const reportName = templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(report.code));
-      if (!diagnosticReportAdded.has(reportName)) {
+      const reportName = templateUtilities.renderTextAsHtml(templateUtilities.codeableConceptDisplay(report.code));
+      const codeAndSystem = templateUtilities.codeableConceptCoding(report.code);
+      if (!diagnosticReportAdded.has(reportName) && !diagnosticReportAdded.has(codeAndSystem)) {
         diagnosticReportAdded.add(reportName);
+        diagnosticReportAdded.add(codeAndSystem);
         let resultCount = "";
         if (report.result && Array.isArray(report.result)) {
           resultCount = `${report.result.length} result${report.result.length !== 1 ? "s" : ""}`;
@@ -3019,9 +3391,11 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
         html += `
           <tr id="${templateUtilities.narrativeLinkId(report)}">
             <td>${reportName}</td>
+            <td>${codeAndSystem}</td>
             <td>${templateUtilities.firstFromCodeableConceptList(report.category)}</td>
             <td>${resultCount}</td>
             <td>${report.issued ? templateUtilities.renderTime(report.issued, timezone) : ""}</td>
+            <td>${templateUtilities.getOwnerTag(report)}</td>
           </tr>`;
       }
     }
@@ -3030,6 +3404,26 @@ var DiagnosticResultsTemplate = class _DiagnosticResultsTemplate {
       </table>`;
     return html;
   }
+  /**
+   * Helper to determine if a DiagnosticReport is just a panel (i.e., only references Observations, has no conclusion, and code is a known panel code)
+   * @returns true if the report is just a panel
+   */
+  static isPanelDiagnosticReport(report) {
+    return this.hasEssentialLabPanelLoinc(
+      report
+    );
+  }
+  /**
+   * Check if a DiagnosticReport or Observation has a LOINC code in ESSENTIAL_LAB_PANELS
+   * @param resource - DiagnosticReport or Observation
+   * @returns true if any LOINC code is in ESSENTIAL_LAB_PANELS, false otherwise
+   */
+  static hasEssentialLabPanelLoinc(resource) {
+    const codings = resource?.code?.coding ?? [];
+    return codings.some(
+      (coding) => coding && coding.system && coding.code && coding.system.toLowerCase().includes("loinc") && Object.keys(ESSENTIAL_LAB_PANELS).includes(coding.code)
+    );
+  }
 };
 
 // src/narratives/templates/typescript/HistoryOfProceduresTemplate.ts
@@ -3063,14 +3457,18 @@ var HistoryOfProceduresTemplate = class _HistoryOfProceduresTemplate {
           <thead>
             <tr>
               <th>Procedure</th>
+              <th>Code (System)</th>
               <th>Performer</th>
               <th>Date</th>
+              <th>Source</th>
             </tr>
           </thead>
           <tbody>`;
     for (const resourceItem of resources) {
       for (const rowData of resourceItem.section ?? []) {
+        const sectionCodeableConcept = rowData.code;
         const data = {};
+        data["codeSystem"] = templateUtilities.codeableConceptCoding(sectionCodeableConcept);
         for (const columnData of rowData.section ?? []) {
           switch (columnData.title) {
             case "Procedure Name":
@@ -3082,6 +3480,9 @@ var HistoryOfProceduresTemplate = class _HistoryOfProceduresTemplate {
             case "Performed Date":
               data["date"] = columnData.text?.div ?? "";
               break;
+            case "Source":
+              data["source"] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
+              break;
             default:
               break;
           }
@@ -3089,9 +3490,11 @@ var HistoryOfProceduresTemplate = class _HistoryOfProceduresTemplate {
         isSummaryCreated = true;
         html += `
             <tr>
-              <td>${data["procedure"] ?? "-"}</td>
-              <td>${data["performer"] ?? "-"}</td>
-              <td>${templateUtilities.renderTime(data["date"], timezone) ?? "-"}</td>
+              <td>${data["procedure"] ?? ""}</td>
+               <td>${data["codeSystem"] ?? ""}</td>
+              <td>${data["performer"] ?? ""}</td>
+              <td>${templateUtilities.renderTime(data["date"], timezone) ?? ""}</td>
+                <td>${data["source"] ?? ""}</td>
             </tr>`;
       }
     }
@@ -3114,8 +3517,10 @@ var HistoryOfProceduresTemplate = class _HistoryOfProceduresTemplate {
         <thead>
           <tr>
             <th>Procedure</th>
+            <th>Code (System)</th>
             <th>Comments</th>
             <th>Date</th>
+            <th>Source</th>
           </tr>
         </thead>
         <tbody>`;
@@ -3123,9 +3528,11 @@ var HistoryOfProceduresTemplate = class _HistoryOfProceduresTemplate {
       const proc = resourceItem;
       html += `
         <tr id="${templateUtilities.narrativeLinkId(proc)}">
-          <td>${templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(proc.code, "display"))}</td>
+          <td>${templateUtilities.renderTextAsHtml(templateUtilities.codeableConceptDisplay(proc.code, "display"))}</td>
+           <td>${templateUtilities.codeableConceptCoding(proc.code)}</td>
           <td>${templateUtilities.renderNotes(proc.note, timezone)}</td>
           <td>${proc.performedDateTime ? templateUtilities.renderTime(proc.performedDateTime, timezone) : proc.performedPeriod ? templateUtilities.renderPeriod(proc.performedPeriod, timezone) : ""}</td>
+            <td>${templateUtilities.getOwnerTag(proc)}</td>
         </tr>`;
     }
     html += `
@@ -3164,22 +3571,26 @@ var SocialHistoryTemplate = class _SocialHistoryTemplate {
       <table>
         <thead>
           <tr>
-            <th>Code</th>
+            <th>Name</th>
+            <th>Code (System)</th>
             <th>Result</th>
             <th>Unit</th>
             <th>Comments</th>
             <th>Date</th>
+            <th>Source</th>
           </tr>
         </thead>
         <tbody>`;
     for (const obs of observations) {
       html += `
           <tr id="${templateUtilities.narrativeLinkId(obs)}">
-            <td>${templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(obs.code))}</td>
+            <td>${templateUtilities.renderTextAsHtml(templateUtilities.codeableConceptDisplay(obs.code))}</td>
+            <td>${templateUtilities.codeableConceptCoding(obs.code)}</td>
             <td>${templateUtilities.extractObservationValue(obs)}</td>
             <td>${templateUtilities.extractObservationValueUnit(obs)}</td>
             <td>${templateUtilities.renderNotes(obs.note, timezone)}</td>
             <td>${obs.effectiveDateTime ? templateUtilities.renderTime(obs.effectiveDateTime, timezone) : obs.effectivePeriod ? templateUtilities.renderPeriod(obs.effectivePeriod, timezone) : ""}</td>
+            <td>${templateUtilities.getOwnerTag(obs)}</td>
           </tr>`;
     }
     html += `
@@ -3195,14 +3606,26 @@ var PastHistoryOfIllnessTemplate = class {
    * Generate HTML narrative for Past History of Illnesses
    * @param resources - FHIR Condition 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 generating relative dates in the narrative
    * @returns HTML string for rendering
    */
-  // eslint-disable-next-line @typescript-eslint/no-unused-vars
-  generateNarrative(resources, timezone) {
+  generateNarrative(resources, timezone, now) {
     const templateUtilities = new TemplateUtilities(resources);
     let html = ``;
     const resolvedConditions = resources.map((entry) => entry) || [];
-    resolvedConditions.sort((a, b) => {
+    const currentDate = now || /* @__PURE__ */ new Date();
+    const fiveYearsAgo = new Date(currentDate);
+    fiveYearsAgo.setFullYear(currentDate.getFullYear() - 5);
+    let skippedConditions = 0;
+    const filteredConditions = [];
+    for (const cond of resolvedConditions) {
+      if (cond.recordedDate && new Date(cond.recordedDate) >= fiveYearsAgo) {
+        filteredConditions.push(cond);
+      } else {
+        skippedConditions++;
+      }
+    }
+    filteredConditions.sort((a, b) => {
       const dateA = a.recordedDate ? new Date(a.recordedDate).getTime() : 0;
       const dateB = b.recordedDate ? new Date(b.recordedDate).getTime() : 0;
       return dateB - dateA;
@@ -3212,27 +3635,35 @@ var PastHistoryOfIllnessTemplate = class {
           <thead>
             <tr>
               <th>Problem</th>
+              <th>Code (System)</th>
               <th>Onset Date</th>
               <th>Recorded Date</th>
               <th>Resolved Date</th>
+              <th>Source</th>
             </tr>
           </thead>
           <tbody>`;
     const addedConditionCodes = /* @__PURE__ */ new Set();
-    for (const cond of resolvedConditions) {
-      const conditionCode = templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(cond.code));
+    for (const cond of filteredConditions) {
+      const conditionCode = templateUtilities.renderTextAsHtml(templateUtilities.codeableConceptDisplay(cond.code));
       if (!addedConditionCodes.has(conditionCode)) {
         addedConditionCodes.add(conditionCode);
         html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
             <td class="Name">${conditionCode}</td>
+            <td class="CodeSystem">${templateUtilities.codeableConceptCoding(cond.code)}</td>
             <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
             <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
             <td class="ResolvedDate">${templateUtilities.renderDate(cond.abatementDateTime)}</td>
+            <td class="Source">${templateUtilities.getOwnerTag(cond)}</td>
           </tr>`;
       }
     }
     html += `</tbody>
         </table>`;
+    if (skippedConditions > 0) {
+      html += `
+<p><em>${skippedConditions} additional past illnesses older than 5 years ago are present</em></p>`;
+    }
     return html;
   }
 };
@@ -3262,6 +3693,7 @@ var PlanOfCareTemplate = class {
             <th>Comments</th>
             <th>Planned Start</th>
             <th>Planned End</th>
+            <th>Source</th>
           </tr>
         </thead>
         <tbody>`;
@@ -3273,6 +3705,7 @@ var PlanOfCareTemplate = class {
             <td>${templateUtilities.concat(cp.note, "text")}</td>
             <td>${cp.period?.start ? templateUtilities.renderTime(cp.period?.start, timezone) : ""}</td>
             <td>${cp.period?.end ? templateUtilities.renderTime(cp.period?.end, timezone) : ""}</td>
+            <td>${templateUtilities.getOwnerTag(cp)}</td>
           </tr>`;
     }
     html += `
@@ -3298,6 +3731,7 @@ var PlanOfCareTemplate = class {
               <th>Created</th>
               <th>Planned Start</th>
               <th>Planned End</th>
+              <th>Source</th>
             </tr>
           </thead>
           <tbody>`;
@@ -3315,10 +3749,11 @@ var PlanOfCareTemplate = class {
         isSummaryCreated = true;
         html += `
             <tr>
-              <td>${data["CarePlan Name"] ?? "-"}</td>
-              <td>${templateUtilities.renderTime(data["created"], timezone) ?? "-"}</td>
-              <td>${templateUtilities.renderTime(data["period.start"], timezone) ?? "-"}</td>
-              <td>${templateUtilities.renderTime(data["period.end"], timezone) ?? "-"}</td>
+              <td>${data["CarePlan Name"] ?? ""}</td>
+              <td>${templateUtilities.renderTime(data["created"], timezone) ?? ""}</td>
+              <td>${templateUtilities.renderTime(data["period.start"], timezone) ?? ""}</td>
+              <td>${templateUtilities.renderTime(data["period.end"], timezone) ?? ""}</td>
+                <td>${data["source"] ?? ""}</td>
             </tr>`;
       }
     }
@@ -3349,77 +3784,54 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
    */
   static generateStaticNarrative(resources, timezone) {
     const templateUtilities = new TemplateUtilities(resources);
-    let html = ``;
-    const activeConditions = [];
-    const clinicalImpressions = [];
-    for (const resourceItem of resources) {
-      if (resourceItem.resourceType === "Condition") {
-        activeConditions.push(resourceItem);
-      } else if (resourceItem.resourceType === "ClinicalImpression") {
-        clinicalImpressions.push(resourceItem);
-      }
-    }
-    activeConditions.sort((a, b) => {
-      const dateA = a.recordedDate ? new Date(a.recordedDate).getTime() : 0;
-      const dateB = b.recordedDate ? new Date(b.recordedDate).getTime() : 0;
-      return dateB - dateA;
+    let html = "";
+    let functionalObservations = resources.filter((r) => r.resourceType === "Observation").filter((r) => {
+      const hasFunctionalLoinc = r.code?.coding?.some(
+        (c) => c.system?.toLowerCase().includes("loinc") && c.code === "47420-5"
+      );
+      const hasFunctionalCategory = r.category?.some(
+        (cat) => cat.coding?.some(
+          (c) => c.code === "functional-status" || c.display?.toLowerCase().includes("functional")
+        )
+      );
+      return hasFunctionalLoinc || hasFunctionalCategory;
     });
-    clinicalImpressions.sort((a, b) => {
-      const dateA = a.effectiveDateTime ? new Date(a.effectiveDateTime).getTime() : a.effectivePeriod?.start ? new Date(a.effectivePeriod.start).getTime() : a.date ? new Date(a.date).getTime() : 0;
-      const dateB = b.effectiveDateTime ? new Date(b.effectiveDateTime).getTime() : b.effectivePeriod?.start ? new Date(b.effectivePeriod.start).getTime() : b.date ? new Date(b.date).getTime() : 0;
-      return dateB - dateA;
+    functionalObservations = functionalObservations.sort((a, b) => {
+      const getObsDate = (obs) => obs.effectiveDateTime ? new Date(obs.effectiveDateTime).getTime() : obs.issued ? new Date(obs.issued).getTime() : 0;
+      return getObsDate(b) - getObsDate(a);
     });
-    if (activeConditions.length > 0) {
-      html += `<h3>Conditions</h3>
-        <table>
-          <thead>
-            <tr>
-              <th>Problem</th>
-              <th>Onset Date</th>
-              <th>Recorded Date</th>
-            </tr>
-          </thead>
-          <tbody>`;
-      const addedConditionCodes = /* @__PURE__ */ new Set();
-      for (const cond of activeConditions) {
-        const conditionCode = templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(cond.code));
-        if (!addedConditionCodes.has(conditionCode)) {
-          addedConditionCodes.add(conditionCode);
-          html += `<tr id="${templateUtilities.narrativeLinkId(cond)}">
-            <td class="Name">${conditionCode}</td>
-            <td class="OnsetDate">${templateUtilities.renderDate(cond.onsetDateTime)}</td>
-            <td class="RecordedDate">${templateUtilities.renderDate(cond.recordedDate)}</td>
-          </tr>`;
-        }
+    let clinicalImpressions = resources.filter((r) => r.resourceType === "ClinicalImpression").filter((r) => r.status === "completed");
+    clinicalImpressions = clinicalImpressions.sort((a, b) => {
+      const getImpressionDate = (ci) => ci.effectiveDateTime ? new Date(ci.effectiveDateTime).getTime() : ci.effectivePeriod?.end ? new Date(ci.effectivePeriod.end).getTime() : ci.date ? new Date(ci.date).getTime() : 0;
+      return getImpressionDate(b) - getImpressionDate(a);
+    });
+    if (functionalObservations.length > 0) {
+      html += `<table><thead><tr><th>Observation</th><th>Value</th><th>Date</th><th>Interpretation</th><th>Comments</th></tr></thead><tbody>`;
+      for (const obs of functionalObservations) {
+        const observation = obs;
+        const obsName = templateUtilities.codeableConceptDisplay(observation.code);
+        const value = templateUtilities.extractObservationValue(observation);
+        const date = observation.effectiveDateTime ? templateUtilities.renderDate(observation.effectiveDateTime) : observation.issued ? templateUtilities.renderDate(observation.issued) : "";
+        const interpretation = observation.interpretation ? templateUtilities.codeableConceptDisplay(observation.interpretation[0]) : "";
+        const comments = observation.comment || observation.note?.map((n) => n.text).join("; ") || "";
+        html += `<tr id="${templateUtilities.narrativeLinkId(observation)}">
+          <td>${obsName}</td>
+          <td>${value ?? ""}</td>
+          <td>${date}</td>
+          <td>${interpretation}</td>
+          <td>${comments}</td>
+        </tr>`;
       }
-      html += `</tbody>
-        </table>`;
+      html += `</tbody></table>`;
     }
     if (clinicalImpressions.length > 0) {
-      html += `<h3>Clinical Impressions</h3>
-      <table>
-        <thead>
-          <tr>
-            <th>Date</th>
-            <th>Status</th>
-            <th>Description</th>
-            <th>Summary</th>
-            <th>Findings</th>
-          </tr>
-        </thead>
-        <tbody>`;
+      html += `<table><thead><tr><th>Date</th><th>Status</th><th>Description</th><th>Summary</th><th>Findings</th></tr></thead><tbody>`;
       for (const impression of clinicalImpressions) {
         let formattedDate = "";
         if (impression.effectiveDateTime) {
-          formattedDate = templateUtilities.renderTime(
-            impression.effectiveDateTime,
-            timezone
-          );
+          formattedDate = templateUtilities.renderTime(impression.effectiveDateTime, timezone);
         } else if (impression.effectivePeriod) {
-          formattedDate = templateUtilities.renderPeriod(
-            impression.effectivePeriod,
-            timezone
-          );
+          formattedDate = templateUtilities.renderPeriod(impression.effectivePeriod, timezone);
         } else if (impression.date) {
           formattedDate = templateUtilities.renderDate(impression.date);
         }
@@ -3427,23 +3839,24 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
         if (impression.finding && impression.finding.length > 0) {
           findingsHtml = "<ul>";
           for (const finding of impression.finding) {
-            const findingText = finding.itemCodeableConcept ? templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(finding.itemCodeableConcept)) : finding.itemReference ? templateUtilities.renderReference(finding.itemReference) : "";
+            const findingText = finding.itemCodeableConcept ? templateUtilities.codeableConceptDisplay(finding.itemCodeableConcept) : finding.itemReference ? templateUtilities.renderReference(finding.itemReference) : "";
             const cause = finding.basis || "";
             findingsHtml += `<li>${findingText}${cause ? ` - ${cause}` : ""}</li>`;
           }
           findingsHtml += "</ul>";
         }
-        html += `
-          <tr id="${templateUtilities.narrativeLinkId(impression)}">
-            <td>${formattedDate}</td>
-            <td>${impression.status || ""}</td>
-            <td>${impression.description || ""}</td>
-            <td>${impression.summary || ""}</td>
-            <td>${findingsHtml}</td>
-          </tr>`;
+        html += `<tr id="${templateUtilities.narrativeLinkId(impression)}">
+          <td>${formattedDate}</td>
+          <td>${impression.status || ""}</td>
+          <td>${impression.description || ""}</td>
+          <td>${impression.summary || ""}</td>
+          <td>${findingsHtml}</td>
+        </tr>`;
       }
-      html += `</tbody>
-        </table>`;
+      html += `</tbody></table>`;
+    }
+    if (functionalObservations.length === 0 && clinicalImpressions.length === 0) {
+      html += `<p>No functional status information available.</p>`;
     }
     return html;
   }
@@ -3468,34 +3881,109 @@ var PregnancyTemplate = class _PregnancyTemplate {
    */
   static generateStaticNarrative(resources, timezone) {
     const templateUtilities = new TemplateUtilities(resources);
-    const observations = resources.map((entry) => entry) || [];
-    observations.sort((a, b) => {
+    const pregnancyHistoryFilter = IPSSectionResourceFilters["HistoryOfPregnancySection"];
+    const filteredResources = pregnancyHistoryFilter ? resources.filter(pregnancyHistoryFilter) : resources;
+    const observations = filteredResources.filter((r) => r.resourceType === "Observation");
+    const conditions = filteredResources.filter((r) => r.resourceType === "Condition");
+    const EDD_LOINC = "11778-8";
+    const pregnancyStatusCodes = Object.keys(PREGNANCY_LOINC_CODES.PREGNANCY_STATUS);
+    const pregnancyOutcomeCodes = Object.keys(PREGNANCY_LOINC_CODES.PREGNANCY_OUTCOME);
+    const pregnancyStatusObs = observations.filter((obs) => obs.code?.coding?.some((c) => c.code && pregnancyStatusCodes.includes(c.code))).sort((a, b) => {
       const dateA = a.effectiveDateTime || a.effectivePeriod?.start;
       const dateB = b.effectiveDateTime || b.effectivePeriod?.start;
-      return dateA && dateB ? new Date(dateB).getTime() - new Date(dateA).getTime() : 0;
+      return dateB && dateA ? new Date(dateB).getTime() - new Date(dateA).getTime() : 0;
+    })[0];
+    const eddObs = observations.filter((obs) => obs.code?.coding?.some((c) => c.code === EDD_LOINC)).sort((a, b) => {
+      const dateA = a.effectiveDateTime || a.effectivePeriod?.start;
+      const dateB = b.effectiveDateTime || b.effectivePeriod?.start;
+      return dateB && dateA ? new Date(dateB).getTime() - new Date(dateA).getTime() : 0;
+    })[0];
+    const historyObs = observations.filter(
+      (obs) => obs.code?.coding?.some((c) => c.code && pregnancyOutcomeCodes.includes(c.code)) || obs.valueCodeableConcept?.coding?.some((c) => c.code && pregnancyOutcomeCodes.includes(c.code))
+    ).sort((a, b) => {
+      const dateA = a.effectiveDateTime || a.effectivePeriod?.start;
+      const dateB = b.effectiveDateTime || b.effectivePeriod?.start;
+      return dateB && dateA ? new Date(dateB).getTime() - new Date(dateA).getTime() : 0;
     });
+    if (!pregnancyStatusObs && !eddObs && historyObs.length === 0 && conditions.length === 0) {
+      return `<p>No history of pregnancy found.</p>`;
+    }
     let html = `
-        <table>
-          <thead>
-            <tr>
-              <th>Result</th>
-              <th>Comments</th>
-              <th>Date</th>
-            </tr>
-          </thead>
-          <tbody>`;
-    for (const resource of observations) {
-      const obs = resource;
+            <table>
+              <thead>
+                <tr>
+                  <th>Result</th>
+                  <th>Code (System)</th>
+                  <th>Comments</th>
+                  <th>Date</th>
+                  <th>Source</th>
+                </tr>
+              </thead>
+              <tbody>`;
+    function renderRow({ id, result, comments, date, codeSystem, owner }) {
       html += `
-          <tr id="${templateUtilities.narrativeLinkId(obs)}">
-            <td>${templateUtilities.renderTextAsHtml(templateUtilities.extractPregnancyStatus(obs))}</td>
-            <td>${templateUtilities.renderNotes(obs.note, timezone)}</td>
-            <td>${obs.effectiveDateTime ? templateUtilities.renderTextAsHtml(templateUtilities.renderTime(obs.effectiveDateTime, timezone)) : obs.effectivePeriod ? templateUtilities.renderTextAsHtml(templateUtilities.renderPeriod(obs.effectivePeriod, timezone)) : ""}</td>
-          </tr>`;
+                <tr id="${id}">
+                  <td class="Result">${result}</td>
+                  <td class="CodeSystem">${codeSystem}</td>
+                  <td class="Comments">${comments}</td>
+                  <td class="Date">${date}</td>
+                  <td class="Source">${owner}</td>
+                </tr>`;
+    }
+    const rowResources = [];
+    if (pregnancyStatusObs) {
+      const date = pregnancyStatusObs.effectiveDateTime || pregnancyStatusObs.effectivePeriod?.start;
+      rowResources.push({ resource: pregnancyStatusObs, date, type: "status" });
+    }
+    if (eddObs) {
+      const date = eddObs.effectiveDateTime || eddObs.effectivePeriod?.start;
+      rowResources.push({ resource: eddObs, date, type: "edd" });
+    }
+    for (const obs of historyObs) {
+      const date = obs.effectiveDateTime || obs.effectivePeriod?.start;
+      rowResources.push({ resource: obs, date, type: "history" });
+    }
+    for (const cond of conditions) {
+      const condition = cond;
+      const date = condition.onsetDateTime || condition.onsetPeriod?.start;
+      rowResources.push({ resource: condition, date, type: "condition" });
+    }
+    rowResources.sort((a, b) => {
+      if (!a.date && !b.date) return 0;
+      if (!a.date) return 1;
+      if (!b.date) return -1;
+      return new Date(b.date).getTime() - new Date(a.date).getTime();
+    });
+    for (const { resource, date, type } of rowResources) {
+      let result = "", comments = "", dateStr = "", codeSystem = "";
+      const id = templateUtilities.narrativeLinkId(resource);
+      if (type === "status") {
+        result = templateUtilities.renderTextAsHtml(templateUtilities.extractPregnancyStatus(resource));
+        comments = templateUtilities.renderNotes(resource.note, timezone);
+        dateStr = date ? templateUtilities.renderTextAsHtml(templateUtilities.renderTime(date, timezone)) : "";
+        codeSystem = templateUtilities.renderTextAsHtml(templateUtilities.codeableConceptCoding(resource.code));
+      } else if (type === "edd") {
+        result = "Estimated Delivery Date: " + templateUtilities.renderTextAsHtml(templateUtilities.extractObservationSummaryValue(resource, timezone));
+        comments = templateUtilities.renderNotes(resource.note, timezone);
+        dateStr = date ? templateUtilities.renderTextAsHtml(templateUtilities.renderTime(date, timezone)) : "";
+        codeSystem = templateUtilities.renderTextAsHtml(templateUtilities.codeableConceptCoding(resource.code));
+      } else if (type === "history") {
+        result = templateUtilities.renderTextAsHtml(templateUtilities.extractPregnancyStatus(resource));
+        comments = templateUtilities.renderNotes(resource.note, timezone);
+        dateStr = date ? templateUtilities.renderTextAsHtml(templateUtilities.renderTime(date, timezone)) : "";
+        codeSystem = templateUtilities.renderTextAsHtml(templateUtilities.codeableConceptCoding(resource.code));
+      } else if (type === "condition") {
+        result = templateUtilities.renderTextAsHtml(templateUtilities.codeableConceptDisplay(resource.code));
+        comments = templateUtilities.renderNotes(resource.note, timezone);
+        dateStr = date ? templateUtilities.renderTextAsHtml(templateUtilities.renderTime(date, timezone)) : "";
+        codeSystem = templateUtilities.renderTextAsHtml(templateUtilities.codeableConceptCoding(resource.code));
+      }
+      const owner = templateUtilities.getOwnerTag(resource);
+      renderRow({ id, result, comments, date: dateStr, codeSystem, owner });
     }
     html += `
-        </tbody>
-      </table>`;
+              </tbody>
+            </table>`;
     return html;
   }
 };
@@ -3540,7 +4028,7 @@ var AdvanceDirectivesTemplate = class _AdvanceDirectivesTemplate {
       const consent = resourceItem;
       html += `
         <tr id="${templateUtilities.narrativeLinkId(consent)}">
-          <td>${templateUtilities.renderTextAsHtml(templateUtilities.codeableConcept(consent.scope, "display"))}</td>
+          <td>${templateUtilities.renderTextAsHtml(templateUtilities.codeableConceptDisplay(consent.scope, "display"))}</td>
           <td>${consent.status || ""}</td>
           <td>${consent.provision?.action ? templateUtilities.concatCodeableConcept(consent.provision.action) : ""}</td>
           <td>${consent.dateTime || ""}</td>
@@ -3573,7 +4061,7 @@ var TypeScriptTemplateMapper = class {
       resources,
       timezone,
       now
-    ) : templateClass.generateNarrative(resources, timezone);
+    ) : templateClass.generateNarrative(resources, timezone, now);
   }
 };
 // Map of section types to their template classes
@@ -3852,6 +4340,12 @@ var ComprehensiveIPSCompositionBuilder = class {
       if (sectionType === "Patient" /* PATIENT */) {
         continue;
       }
+      const summaryIPSCompositionFilter = useSummaryCompositions ? IPSSectionResourceHelper.getSummaryIPSCompositionFilterForSection(sectionType) : void 0;
+      const sectionIPSSummary = summaryIPSCompositionFilter ? resources.filter((resource) => summaryIPSCompositionFilter(resource)) : [];
+      if (sectionIPSSummary.length > 0) {
+        await this.makeSectionFromSummaryAsync(sectionType, sectionIPSSummary, resources, timezone);
+        continue;
+      }
       const summaryCompositionFilter = useSummaryCompositions ? IPSSectionResourceHelper.getSummaryCompositionFilterForSection(sectionType) : void 0;
       const sectionSummary = summaryCompositionFilter ? resources.filter((resource) => summaryCompositionFilter(resource)) : [];
       if (sectionSummary.length > 0) {