@imranq2/fhirpatientsummary 1.0.33 → 1.0.34

package/README.md

@@ -64,6 +64,44 @@ console.log(JSON.stringify(bundle, null, 2));
 - Use `makeSectionAsync(sectionType, resources, timezone)` to add each IPS section, or use `read_bundle(fhirBundle, timezone)` to extract all supported sections from a FHIR Bundle.
 - Use `build_bundle` to generate the final FHIR Bundle.
 
+## Patient Summary Composition
+
+When generating patient summaries from FHIR Bundles, the library can use pre-computed summary compositions instead of raw resources. Summary compositions are specially structured FHIR Composition resources that contain curated, filtered, or aggregated data for specific sections.
+
+### How Summary Compositions Work
+
+The `readBundleAsync` method supports a `useSummaryCompositions` parameter. When enabled, the library follows this priority order when processing each IPS section:
+
+1. **IPS-Specific Composition** (highest priority): Compositions with IPS-specific type codes (e.g., `ips_patient_summary_document`, `ips_vital_summary_document`)
+2. **Summary Composition** (medium priority): Compositions with summary type codes (e.g., `allergy_summary_document`, `condition_summary_document`, `medication_summary_document`)
+3. **Raw Resources** (fallback): Individual FHIR resources when no composition is available
+
+This priority order ensures that the most refined and curated data is used when available, while still supporting raw resource processing as a fallback.
+
+### Environment Variables for enabling Composition Summary
+
+The following environment variables can be used to configure the behavior of the patient summary generator:
+
+#### SUMMARY_IPS_COMPOSITION_SECTIONS
+
+Controls which IPS sections should include IPS-specific composition.
+
+- **Default**: Disabled
+- **Format**: Comma-separated list of section names
+- **Example**: `SUMMARY_IPS_COMPOSITION_SECTIONS=Patient,VitalSignsSection`
+
+When set to `all`, all supported sections will use IPS composition. To enable only specific sections, provide a comma-separated list of [section names](src/structures/ips_sections.ts).
+
+#### SUMMARY_COMPOSITION_SECTIONS
+
+Controls which IPS sections should include summary composition.
+
+- **Default**: Disabled
+- **Format**: Comma-separated list of section names
+- **Example**: `SUMMARY_COMPOSITION_SECTIONS=AllergyIntoleranceSection,ProblemSection,MedicationSummarySection`
+
+When set to `all`, all supported sections will use summary composition. To enable only specific sections, provide a comma-separated list of [section names](src/structures/ips_sections.ts).
+
 ## Running Tests
 
 To run the test suite:

package/dist/index.cjs

@@ -189,6 +189,8 @@ var IPSSectionResourceFilters = {
 };
 var IPSSectionSummaryCompositionFilter = {
   ["AllergyIntoleranceSection" /* ALLERGIES */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => codingMatches(c, "allergy_summary_document", IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM)),
+  ["ProblemSection" /* PROBLEMS */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => codingMatches(c, "condition_summary_document", IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM)),
+  ["HistoryOfPastIllnessSection" /* MEDICAL_HISTORY */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => codingMatches(c, "condition_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)),
@@ -210,10 +212,16 @@ var IPSSectionResourceHelper = class {
     return resources.filter(filter);
   }
   static getSummaryCompositionFilterForSection(section) {
-    return IPSSectionSummaryCompositionFilter[section];
+    const sectionCompositionEnabled = process.env.SUMMARY_COMPOSITION_SECTIONS ? process.env.SUMMARY_COMPOSITION_SECTIONS.split(",").some(
+      (s) => s.trim().toLowerCase() === section.toString().toLowerCase() || s.trim().toLowerCase() === "all"
+    ) : false;
+    return sectionCompositionEnabled ? IPSSectionSummaryCompositionFilter[section] : void 0;
   }
   static getSummaryIPSCompositionFilterForSection(section) {
-    return IPSSectionSummaryIPSCompositionFilter[section];
+    const sectionIPSCompositionEnabled = process.env.SUMMARY_IPS_COMPOSITION_SECTIONS ? process.env.SUMMARY_IPS_COMPOSITION_SECTIONS.split(",").some(
+      (s) => s.trim().toLowerCase() === section.toString().toLowerCase() || s.trim().toLowerCase() === "all"
+    ) : false;
+    return sectionIPSCompositionEnabled ? IPSSectionSummaryIPSCompositionFilter[section] : void 0;
   }
 };
 function codingMatches(coding, code, system) {
@@ -1478,8 +1486,8 @@ var PatientTemplate = class _PatientTemplate {
         <li><strong>Date of Birth:</strong>${data["Date of Birth"] || ""}</li>
         <li><strong>Telecom:</strong>${data["Telecom"] || ""}</li>
         <li><strong>Address(es):</strong>${data["Address"] || ""}</li>
-        <li><strong>Marital Status:</strong> ${data["Marital Status"] || ""}</li>
-        <li><strong>Deceased:</strong>${data["Deceased"] || ""}</li>
+        ${data["Marital Status"] ? `<li><strong>Marital Status:</strong>${data["Marital Status"]}</li>` : ""}
+        ${data["Deceased"] ? `<li><strong>Deceased:</strong>${data["Deceased"]}</li>` : ""}
         <li><strong>Language(s):</strong>${data["Communication"] || ""}</li>
       </ul>
     </div>`;
@@ -1495,6 +1503,7 @@ var PatientTemplate = class _PatientTemplate {
   static generateStaticNarrative(resources, timezone) {
     const templateUtilities = new TemplateUtilities(resources);
     const combinedPatient = this.combinePatients(resources);
+    const deceasedText = this.renderDeceased(combinedPatient);
     let html = `<p>This section merges all Patient resources into a single combined patient record, preferring non-empty values for each field.</p>`;
     html += `<div>
       <ul>
@@ -1503,8 +1512,8 @@ var PatientTemplate = class _PatientTemplate {
         <li><strong>Date of Birth:</strong>${combinedPatient.birthDate || ""}</li>
         <li><strong>Telecom:</strong><ul>${this.renderTelecom(combinedPatient)}</ul></li>
         <li><strong>Address(es):</strong>${this.renderAddresses(combinedPatient)}</li>
-        <li><strong>Marital Status:</strong> ${combinedPatient.maritalStatus?.text || ""}</li>
-        <li><strong>Deceased:</strong>${this.renderDeceased(combinedPatient)}</li>
+        ${combinedPatient.maritalStatus?.text ? `<li><strong>Marital Status:</strong> ${combinedPatient.maritalStatus.text}</li>` : ""}
+        ${deceasedText ? `<li><strong>Deceased:</strong>${deceasedText}</li>` : ""}
         <li><strong>Language(s):</strong>${this.renderCommunication(templateUtilities, combinedPatient)}</li>
       </ul>
     </div>`;
@@ -2446,6 +2455,59 @@ var ProblemListTemplate = class _ProblemListTemplate {
   generateNarrative(resources, timezone) {
     return _ProblemListTemplate.generateStaticNarrative(resources, timezone);
   }
+  /**
+   * Generate HTML narrative for Condition resources using summary
+   * @param resources - FHIR Composition resources
+   * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
+   * @returns HTML string for rendering
+   */
+  generateSummaryNarrative(resources, timezone) {
+    const templateUtilities = new TemplateUtilities(resources);
+    let isSummaryCreated = false;
+    let html = `<p>This list includes patient problems, sorted by recorded date (most recent first)</p>
+      <div>
+        <table>
+          <thead>
+            <tr>
+              <th>Problem</th>
+              <th>Code (System)</th>
+              <th>Is Chronic</th>
+              <th>Onset Date</th>
+              <th>Last Confirmed Date</th>
+            </tr>
+          </thead>
+          <tbody>`;
+    for (const resourceItem of resources) {
+      for (const rowData of resourceItem.section ?? []) {
+        const sectionCodeableConcept = rowData.code;
+        const data = {};
+        for (const columnData of rowData.section ?? []) {
+          if (columnData.title) {
+            data[columnData.title] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
+          }
+        }
+        if (data["Condition Name"]?.toLowerCase() === "unknown") {
+          continue;
+        }
+        if (data["Status"] === "active") {
+          isSummaryCreated = true;
+          html += `
+              <tr>
+                <td>${templateUtilities.capitalizeFirstLetter(data["Condition Name"] ?? "")}</td>
+                <td>${templateUtilities.codeableConceptCoding(sectionCodeableConcept)}</td>
+                <td>${data["Is Chronic"] ?? ""}</td>
+                <td>${templateUtilities.renderTime(data["Onset Date"], timezone) ?? ""}</td>
+                <td>${templateUtilities.renderTime(data["Last Confirmed Date"], timezone) ?? ""}</td> 
+              </tr>`;
+        }
+      }
+    }
+    html += `
+          </tbody>
+        </table>
+      </div>`;
+    return isSummaryCreated ? html : void 0;
+  }
   /**
    * Internal static implementation that actually generates the narrative
    * @param resources - FHIR Condition resources
@@ -3731,6 +3793,73 @@ var PastHistoryOfIllnessTemplate = class {
     }
     return html;
   }
+  /**
+   * Generate HTML narrative for Condition resources using summary
+   * @param resources - FHIR Composition resources
+   * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
+   * @returns HTML string for rendering
+   */
+  generateSummaryNarrative(resources, timezone, now) {
+    const templateUtilities = new TemplateUtilities(resources);
+    let isSummaryCreated = false;
+    const currentDate = now || /* @__PURE__ */ new Date();
+    const fiveYearsAgo = new Date(currentDate);
+    fiveYearsAgo.setFullYear(currentDate.getFullYear() - 5);
+    let skippedConditions = 0;
+    let html = `<p>This list includes past problems for the patient with a recorded date within the last 5 years, sorted by recorded date (most recent first).</p>
+      <div>
+        <table>
+          <thead>
+            <tr>
+              <th>Problem</th>
+              <th>Code (System)</th>
+              <th>Is Chronic</th>
+              <th>Onset Date</th>
+              <th>Last Confirmed Date</th>
+              <th>Resolved Date</th>
+            </tr>
+          </thead>
+          <tbody>`;
+    for (const resourceItem of resources) {
+      for (const rowData of resourceItem.section ?? []) {
+        const sectionCodeableConcept = rowData.code;
+        const data = {};
+        for (const columnData of rowData.section ?? []) {
+          if (columnData.title) {
+            data[columnData.title] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
+          }
+        }
+        if (data["Condition Name"]?.toLowerCase() === "unknown") {
+          continue;
+        }
+        if (data["Status"] === "inactive") {
+          if (data["Last Confirmed Date"] && new Date(data["Last Confirmed Date"]) < fiveYearsAgo) {
+            skippedConditions++;
+            continue;
+          }
+          isSummaryCreated = true;
+          html += `
+              <tr>
+                <td>${templateUtilities.capitalizeFirstLetter(data["Condition Name"] ?? "")}</td>
+                <td>${templateUtilities.codeableConceptCoding(sectionCodeableConcept)}</td>
+                <td>${data["Is Chronic"] ?? ""}</td>
+                <td>${templateUtilities.renderTime(data["Onset Date"], timezone) ?? ""}</td>
+                <td>${templateUtilities.renderTime(data["Last Confirmed Date"], timezone) ?? ""}</td> 
+                <td>${templateUtilities.renderTime(data["Resolved Date"], timezone) ?? ""}</td>
+              </tr>`;
+        }
+      }
+    }
+    html += `
+          </tbody>
+        </table>`;
+    if (skippedConditions > 0) {
+      html += `
+<p><em>${skippedConditions} additional past illnesses older than 5 years ago are present</em></p>`;
+    }
+    html += `</div>`;
+    return isSummaryCreated ? html : void 0;
+  }
 };
 
 // src/narratives/templates/typescript/PlanOfCareTemplate.ts

package/dist/index.js

@@ -161,6 +161,8 @@ var IPSSectionResourceFilters = {
 };
 var IPSSectionSummaryCompositionFilter = {
   ["AllergyIntoleranceSection" /* ALLERGIES */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => codingMatches(c, "allergy_summary_document", IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM)),
+  ["ProblemSection" /* PROBLEMS */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => codingMatches(c, "condition_summary_document", IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM)),
+  ["HistoryOfPastIllnessSection" /* MEDICAL_HISTORY */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => codingMatches(c, "condition_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)),
@@ -182,10 +184,16 @@ var IPSSectionResourceHelper = class {
     return resources.filter(filter);
   }
   static getSummaryCompositionFilterForSection(section) {
-    return IPSSectionSummaryCompositionFilter[section];
+    const sectionCompositionEnabled = process.env.SUMMARY_COMPOSITION_SECTIONS ? process.env.SUMMARY_COMPOSITION_SECTIONS.split(",").some(
+      (s) => s.trim().toLowerCase() === section.toString().toLowerCase() || s.trim().toLowerCase() === "all"
+    ) : false;
+    return sectionCompositionEnabled ? IPSSectionSummaryCompositionFilter[section] : void 0;
   }
   static getSummaryIPSCompositionFilterForSection(section) {
-    return IPSSectionSummaryIPSCompositionFilter[section];
+    const sectionIPSCompositionEnabled = process.env.SUMMARY_IPS_COMPOSITION_SECTIONS ? process.env.SUMMARY_IPS_COMPOSITION_SECTIONS.split(",").some(
+      (s) => s.trim().toLowerCase() === section.toString().toLowerCase() || s.trim().toLowerCase() === "all"
+    ) : false;
+    return sectionIPSCompositionEnabled ? IPSSectionSummaryIPSCompositionFilter[section] : void 0;
   }
 };
 function codingMatches(coding, code, system) {
@@ -1450,8 +1458,8 @@ var PatientTemplate = class _PatientTemplate {
         <li><strong>Date of Birth:</strong>${data["Date of Birth"] || ""}</li>
         <li><strong>Telecom:</strong>${data["Telecom"] || ""}</li>
         <li><strong>Address(es):</strong>${data["Address"] || ""}</li>
-        <li><strong>Marital Status:</strong> ${data["Marital Status"] || ""}</li>
-        <li><strong>Deceased:</strong>${data["Deceased"] || ""}</li>
+        ${data["Marital Status"] ? `<li><strong>Marital Status:</strong>${data["Marital Status"]}</li>` : ""}
+        ${data["Deceased"] ? `<li><strong>Deceased:</strong>${data["Deceased"]}</li>` : ""}
         <li><strong>Language(s):</strong>${data["Communication"] || ""}</li>
       </ul>
     </div>`;
@@ -1467,6 +1475,7 @@ var PatientTemplate = class _PatientTemplate {
   static generateStaticNarrative(resources, timezone) {
     const templateUtilities = new TemplateUtilities(resources);
     const combinedPatient = this.combinePatients(resources);
+    const deceasedText = this.renderDeceased(combinedPatient);
     let html = `<p>This section merges all Patient resources into a single combined patient record, preferring non-empty values for each field.</p>`;
     html += `<div>
       <ul>
@@ -1475,8 +1484,8 @@ var PatientTemplate = class _PatientTemplate {
         <li><strong>Date of Birth:</strong>${combinedPatient.birthDate || ""}</li>
         <li><strong>Telecom:</strong><ul>${this.renderTelecom(combinedPatient)}</ul></li>
         <li><strong>Address(es):</strong>${this.renderAddresses(combinedPatient)}</li>
-        <li><strong>Marital Status:</strong> ${combinedPatient.maritalStatus?.text || ""}</li>
-        <li><strong>Deceased:</strong>${this.renderDeceased(combinedPatient)}</li>
+        ${combinedPatient.maritalStatus?.text ? `<li><strong>Marital Status:</strong> ${combinedPatient.maritalStatus.text}</li>` : ""}
+        ${deceasedText ? `<li><strong>Deceased:</strong>${deceasedText}</li>` : ""}
         <li><strong>Language(s):</strong>${this.renderCommunication(templateUtilities, combinedPatient)}</li>
       </ul>
     </div>`;
@@ -2418,6 +2427,59 @@ var ProblemListTemplate = class _ProblemListTemplate {
   generateNarrative(resources, timezone) {
     return _ProblemListTemplate.generateStaticNarrative(resources, timezone);
   }
+  /**
+   * Generate HTML narrative for Condition resources using summary
+   * @param resources - FHIR Composition resources
+   * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
+   * @returns HTML string for rendering
+   */
+  generateSummaryNarrative(resources, timezone) {
+    const templateUtilities = new TemplateUtilities(resources);
+    let isSummaryCreated = false;
+    let html = `<p>This list includes patient problems, sorted by recorded date (most recent first)</p>
+      <div>
+        <table>
+          <thead>
+            <tr>
+              <th>Problem</th>
+              <th>Code (System)</th>
+              <th>Is Chronic</th>
+              <th>Onset Date</th>
+              <th>Last Confirmed Date</th>
+            </tr>
+          </thead>
+          <tbody>`;
+    for (const resourceItem of resources) {
+      for (const rowData of resourceItem.section ?? []) {
+        const sectionCodeableConcept = rowData.code;
+        const data = {};
+        for (const columnData of rowData.section ?? []) {
+          if (columnData.title) {
+            data[columnData.title] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
+          }
+        }
+        if (data["Condition Name"]?.toLowerCase() === "unknown") {
+          continue;
+        }
+        if (data["Status"] === "active") {
+          isSummaryCreated = true;
+          html += `
+              <tr>
+                <td>${templateUtilities.capitalizeFirstLetter(data["Condition Name"] ?? "")}</td>
+                <td>${templateUtilities.codeableConceptCoding(sectionCodeableConcept)}</td>
+                <td>${data["Is Chronic"] ?? ""}</td>
+                <td>${templateUtilities.renderTime(data["Onset Date"], timezone) ?? ""}</td>
+                <td>${templateUtilities.renderTime(data["Last Confirmed Date"], timezone) ?? ""}</td> 
+              </tr>`;
+        }
+      }
+    }
+    html += `
+          </tbody>
+        </table>
+      </div>`;
+    return isSummaryCreated ? html : void 0;
+  }
   /**
    * Internal static implementation that actually generates the narrative
    * @param resources - FHIR Condition resources
@@ -3703,6 +3765,73 @@ var PastHistoryOfIllnessTemplate = class {
     }
     return html;
   }
+  /**
+   * Generate HTML narrative for Condition resources using summary
+   * @param resources - FHIR Composition resources
+   * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
+   * @returns HTML string for rendering
+   */
+  generateSummaryNarrative(resources, timezone, now) {
+    const templateUtilities = new TemplateUtilities(resources);
+    let isSummaryCreated = false;
+    const currentDate = now || /* @__PURE__ */ new Date();
+    const fiveYearsAgo = new Date(currentDate);
+    fiveYearsAgo.setFullYear(currentDate.getFullYear() - 5);
+    let skippedConditions = 0;
+    let html = `<p>This list includes past problems for the patient with a recorded date within the last 5 years, sorted by recorded date (most recent first).</p>
+      <div>
+        <table>
+          <thead>
+            <tr>
+              <th>Problem</th>
+              <th>Code (System)</th>
+              <th>Is Chronic</th>
+              <th>Onset Date</th>
+              <th>Last Confirmed Date</th>
+              <th>Resolved Date</th>
+            </tr>
+          </thead>
+          <tbody>`;
+    for (const resourceItem of resources) {
+      for (const rowData of resourceItem.section ?? []) {
+        const sectionCodeableConcept = rowData.code;
+        const data = {};
+        for (const columnData of rowData.section ?? []) {
+          if (columnData.title) {
+            data[columnData.title] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
+          }
+        }
+        if (data["Condition Name"]?.toLowerCase() === "unknown") {
+          continue;
+        }
+        if (data["Status"] === "inactive") {
+          if (data["Last Confirmed Date"] && new Date(data["Last Confirmed Date"]) < fiveYearsAgo) {
+            skippedConditions++;
+            continue;
+          }
+          isSummaryCreated = true;
+          html += `
+              <tr>
+                <td>${templateUtilities.capitalizeFirstLetter(data["Condition Name"] ?? "")}</td>
+                <td>${templateUtilities.codeableConceptCoding(sectionCodeableConcept)}</td>
+                <td>${data["Is Chronic"] ?? ""}</td>
+                <td>${templateUtilities.renderTime(data["Onset Date"], timezone) ?? ""}</td>
+                <td>${templateUtilities.renderTime(data["Last Confirmed Date"], timezone) ?? ""}</td> 
+                <td>${templateUtilities.renderTime(data["Resolved Date"], timezone) ?? ""}</td>
+              </tr>`;
+        }
+      }
+    }
+    html += `
+          </tbody>
+        </table>`;
+    if (skippedConditions > 0) {
+      html += `
+<p><em>${skippedConditions} additional past illnesses older than 5 years ago are present</em></p>`;
+    }
+    html += `</div>`;
+    return isSummaryCreated ? html : void 0;
+  }
 };
 
 // src/narratives/templates/typescript/PlanOfCareTemplate.ts

package/package.json

@@ -1,6 +1,6 @@
 {
   "name": "@imranq2/fhirpatientsummary",
-  "version": "1.0.33",
+  "version": "1.0.34",
   "description": "A template for creating npm packages using TypeScript and VSCode",
   "main": "./dist/index.js",
   "module": "./dist/index.mjs",