@imranq2/fhirpatientsummary 1.0.37 → 1.0.39

package/dist/index.cjs

@@ -138,6 +138,85 @@ var ESSENTIAL_LAB_PANELS = {
   "80235-8": "Cardiac Markers Panel",
   "69738-3": "CBC with Auto Differential"
 };
+var FUNCTIONAL_STATUS_SNOMED_CODES = {
+  "118233009": "Core Functional Status",
+  "364644000": "Core Functional Status",
+  "160245001": "Core Functional Status",
+  "21134002": "Disability & Impairment",
+  "2655002": "Disability & Impairment",
+  "2219003": "Disability & Impairment",
+  "962000": "Disability & Impairment",
+  "3089009": "Disability & Impairment",
+  "4197006": "Disability & Impairment",
+  "284545001": "Activities of Daily Living",
+  "719930002": "Activities of Daily Living",
+  "301438001": "Activities of Daily Living",
+  "282145008": "Mobility & Movement",
+  "165245003": "Mobility & Movement",
+  "713458007": "Mobility & Movement"
+};
+var FUNCTIONAL_STATUS_ASSESSMENT_LOINC_CODES = {
+  "54522-8": "Functional Status Panel",
+  "54523-6": "ADL Assistance",
+  "45588-1": "Bed Mobility",
+  "45589-9": "Bed Mobility",
+  "45590-7": "Transfer",
+  "45591-5": "Transfer",
+  "45592-3": "Walk in room",
+  "45593-1": "Walk in room",
+  "45594-9": "Walk in corridor",
+  "45595-6": "Walk in corridor",
+  "45596-4": "Locomotion on unit",
+  "45597-2": "Locomotion on unit",
+  "45598-0": "Locomotion off unit",
+  "45599-8": "Locomotion off unit",
+  "45600-4": "Dressing",
+  "45601-2": "Dressing",
+  "45602-0": "Eating",
+  "45603-8": "Eating",
+  "45604-6": "Toilet use",
+  "45605-3": "Toilet use",
+  "45606-1": "Personal hygiene",
+  "45607-9": "Personal hygiene",
+  "46008-9": "Bathing",
+  "45608-7": "Bathing",
+  "45609-5": "Bathing",
+  "54524-4": "Balance during Transitions and Walking",
+  "54749-7": "Moving from Seated to Standing",
+  "54750-5": "Walking with Assistive Device",
+  "54751-3": "Turning Around While Walking",
+  "54753-9": "Surface-to-Surface Transfer",
+  "54525-1": "Functional Limitation in Range of Motion",
+  "54754-7": "Upper Extremity ROM",
+  "54755-4": "Lower Extremity ROM",
+  "54526-9": "Mobility Devices",
+  "54756-2": "Cane/Crutch",
+  "54757-0": "Walker",
+  "54758-8": "Wheelchair",
+  "54759-6": "Limb Prosthesis",
+  "54760-4": "No Mobility Devices",
+  "54527-7": "Functional Rehabilitation Potential",
+  "55123-4": "Resident Believes Capable of Increased Independence",
+  "45613-7": "Staff Believes Capable of Increased Independence"
+};
+var ADVANCED_DIRECTIVE_CATEGORY_CODES = {
+  acd: "Advance Directive",
+  dnr: "Do Not Resuscitate",
+  polst: "POLST",
+  hcd: "Health Care Directive"
+};
+var ADVANCED_DIRECTIVE_CATEGORY_SYSTEM = "http://terminology.hl7.org/CodeSystem/consentcategorycodes";
+var ADVANCED_DIRECTIVE_LOINC_CODES = {
+  "45473-6": "Advance healthcare directive Completed",
+  "45474-4": "Do not resuscitate",
+  "45475-1": "Do not hospitalize",
+  "45476-9": "Organ donation",
+  "45477-7": "Autopsy request",
+  "45478-5": "Feeding restrictions",
+  "45479-3": "Medication restrictions",
+  "45480-1": "Other treatment restrictions"
+};
+var LOINC_SYSTEM = "http://loinc.org";
 
 // src/structures/ips_section_constants.ts
 var VITAL_SIGNS_SUMMARY_COMPONENT_MAP = {
@@ -173,19 +252,16 @@ var IPSSectionResourceFilters = {
   ["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")
-    )
+  // Only include Condition with Functional Status LOINC and SNOMED codes, category code 'problem-list-item', and completed ClinicalImpressions
+  ["FunctionalStatusSection" /* FUNCTIONAL_STATUS */]: (resource) => resource.resourceType === "Condition" && ((codeableConceptMatches(resource.code, Object.keys(FUNCTIONAL_STATUS_ASSESSMENT_LOINC_CODES), "http://loinc.org") || codeableConceptMatches(resource.code, Object.keys(FUNCTIONAL_STATUS_SNOMED_CODES), "http://snomed.info/sct")) && resource.clinicalStatus?.coding?.some((c) => c.code === "active") && resource.category?.some(
+    (cat) => cat.coding?.some((c) => c.code === "problem-list-item")
   )) || 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)
-  // TODO: disable this until we right logic to get these
-  ["AdvanceDirectivesSection" /* ADVANCE_DIRECTIVES */]: () => false
+  ["AdvanceDirectivesSection" /* ADVANCE_DIRECTIVES */]: (resource) => resource.resourceType === "Consent" && resource.status === "active" && resource.scope?.coding?.some((c) => codingMatches(c, "adr", "http://terminology.hl7.org/CodeSystem/consentscope"))
 };
 var IPSSectionSummaryCompositionFilter = {
   ["AllergyIntoleranceSection" /* ALLERGIES */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => codingMatches(c, "allergy_summary_document", IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM)),
@@ -201,8 +277,10 @@ var IPSSectionSummaryCompositionFilter = {
 var IPSSectionSummaryIPSCompositionFilter = {
   ["Patient" /* PATIENT */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => codingMatches(c, "ips_patient_summary_document", IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM)),
   ["VitalSignsSection" /* VITAL_SIGNS */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => codingMatches(c, "ips_vital_summary_document", IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM)),
+  ["AdvanceDirectivesSection" /* ADVANCE_DIRECTIVES */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => codingMatches(c, "ips_advanced_directives_summary_document", IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM)),
   ["SocialHistorySection" /* SOCIAL_HISTORY */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => codingMatches(c, "ips_social_history_summary_document", IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM)),
-  ["FunctionalStatusSection" /* FUNCTIONAL_STATUS */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => codingMatches(c, ["ips_functional_status_condition_summary_document", "ips_functional_status_clinical_impression_summary_document"], IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM))
+  ["FunctionalStatusSection" /* FUNCTIONAL_STATUS */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => codingMatches(c, ["ips_functional_status_condition_summary_document", "ips_functional_status_clinical_impression_summary_document"], IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM)),
+  ["MedicalDeviceSection" /* MEDICAL_DEVICES */]: (resource) => resource.resourceType === "Composition" && resource.type?.coding?.some((c) => codingMatches(c, "ips_medical_device_summary_document", IPS_SUMMARY_COMPOSITION_TYPE_SYSTEM))
 };
 var IPSSectionResourceHelper = class {
   static getResourceFilterForSection(section) {
@@ -334,13 +412,26 @@ var TemplateUtilities = class {
     return code ? `${code} (${systemDisplay})` : "";
   }
   /**
-   * Renders a Device reference
+   * Resolves and returns a Device resource from a Device Reference.
+   * Returns null if the reference cannot be resolved or is not a Device.
    * @param deviceRef - Reference to a Device resource
-   * @returns Formatted device description
+   * @returns The resolved Device resource or null
+   */
+  getDeviceFromReference(deviceRef) {
+    if (!deviceRef) return null;
+    const device = this.resolveReference(deviceRef);
+    return device && device.resourceType === "Device" ? device : null;
+  }
+  /**
+   * Renders a Device name from a Device reference.
+   * Uses getDeviceFromReference to resolve the Device and returns a concatenated device.deviceName.
+   * Returns an empty string if no deviceName is available. The returned text is HTML-safe.
+   * @param deviceRef - Reference to a Device resource
+   * @returns Sanitized device name or empty string
    */
   renderDevice(deviceRef) {
-    const device = deviceRef && this.resolveReference(deviceRef);
-    if (device && device.resourceType === "Device" && device.deviceName && device.deviceName.length > 0) {
+    const device = this.getDeviceFromReference(deviceRef);
+    if (device && device.deviceName && device.deviceName.length > 0) {
       return this.safeConcat(device.deviceName, "name");
     }
     return "";
@@ -2756,11 +2847,64 @@ var MedicalDevicesTemplate = class _MedicalDevicesTemplate {
     return _MedicalDevicesTemplate.generateStaticNarrative(resources, timezone);
   }
   /**
-   * Internal static implementation that actually generates the narrative
-   * @param resources - FHIR resources array containing Device resources
+   * Generate HTML narrative for history of medical devices 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 all information about the patient's medical devices history, sorted by recorded date (most recent first).</p>
+`;
+    html += `
+      <table>
+        <thead>
+          <tr>
+            <th>Device</th>
+            <th>Code (System)</th>
+            <th>Status</th>
+            <th>Comments</th>
+            <th>Date Recorded</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) {
+            data[columnTitle] = templateUtilities.renderTextAsHtml(columnData.text?.div ?? "");
+          }
+        }
+        if (data["Device Name"]?.toLowerCase() === "unknown") {
+          continue;
+        }
+        isSummaryCreated = true;
+        html += `
+          <tr>
+            <td>${templateUtilities.capitalizeFirstLetter(data["Device Name"] ?? "")}</td>
+            <td>${data["codeSystem"] ?? ""}</td>
+            <td>${templateUtilities.renderTextAsHtml(data["Status"] ?? "")}</td>
+            <td>${templateUtilities.renderTextAsHtml(data["Notes"] ?? "")}</td>
+            <td>${templateUtilities.renderTime(data["Recorded On"] ?? "", timezone)}</td>
+            <td>${data["Source"] ?? ""}</td>
+          </tr>`;
+      }
+    }
+    html += `
+          </tbody>
+        </table>`;
+    return isSummaryCreated ? html : void 0;
+  }
+  /**
+   * Internal static implementation that generates the narrative from DeviceUseStatement resources.
+   * The “Code (System)” column renders Device.type as "code (SystemDisplay)" using TemplateUtilities.codeableConceptCoding.
+   */
   static generateStaticNarrative(resources, timezone) {
     const templateUtilities = new TemplateUtilities(resources);
     let html = `<p>This list includes all DeviceUseStatement resources, sorted by recorded date (most recent first).</p>
@@ -2768,6 +2912,7 @@ var MedicalDevicesTemplate = class _MedicalDevicesTemplate {
         <thead>
           <tr>
             <th>Device</th>
+            <th>Code (System)</th>
             <th>Status</th>
             <th>Comments</th>
             <th>Date Recorded</th>
@@ -2780,26 +2925,32 @@ var MedicalDevicesTemplate = class _MedicalDevicesTemplate {
       const dateB = b.recordedOn;
       return typeof dateA === "string" && typeof dateB === "string" ? new Date(dateB).getTime() - new Date(dateA).getTime() : 0;
     });
-    let isDeviceAdded = false;
+    const devicesAdded = /* @__PURE__ */ new Set();
     for (const dus of deviceStatements) {
-      const deviceName = templateUtilities.renderTextAsHtml(templateUtilities.renderDevice(dus.device));
-      if (deviceName?.toLowerCase() === "unknown") {
+      const deviceName = templateUtilities.renderDevice(dus.device);
+      if (deviceName?.toLowerCase() === "unknown" || devicesAdded.has(deviceName)) {
+        continue;
+      }
+      const device = templateUtilities.getDeviceFromReference(dus.device);
+      const codeSystem = templateUtilities.codeableConceptCoding(device?.type);
+      if (!codeSystem) {
         continue;
       }
-      isDeviceAdded = true;
+      devicesAdded.add(deviceName);
       html += `
         <tr>
           <td>${templateUtilities.capitalizeFirstLetter(deviceName)}</td>
+          <td>${codeSystem}</td>
           <td>${templateUtilities.renderTextAsHtml(dus.status || "")}</td>
           <td>${templateUtilities.renderNotes(dus.note, timezone)}</td>
-          <td>${templateUtilities.renderTextAsHtml(templateUtilities.renderRecorded(dus.recordedOn, timezone))}</td>
+          <td>${templateUtilities.renderTime(dus.recordedOn, timezone)}</td>
           <td>${templateUtilities.getOwnerTag(dus)}</td>
         </tr>`;
     }
     html += `
         </tbody>
       </table>`;
-    return isDeviceAdded ? html : void 0;
+    return devicesAdded.size > 0 ? html : void 0;
   }
 };
 
@@ -4103,7 +4254,7 @@ var PlanOfCareTemplate = class {
 var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
   /**
    * Generate HTML narrative for Functional Status
-   * @param resources - FHIR resources array containing Observation resources
+   * @param resources - FHIR resources array containing Condition and ClinicalImpression resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
@@ -4143,8 +4294,8 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
         <thead>
           <tr>
             <th>Name</th>
-            <th>Date</th>
             <th>Code (System)</th>
+            <th>Date</th>
             <th>Description</th>
             <th>Summary</th>
             <th>Source</th>
@@ -4210,8 +4361,8 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
             clinicalImpressionsHtml += `
                 <tr>
                   <td>${templateUtilities.capitalizeFirstLetter(name)}</td>
-                  <td>${date ?? ""}</td>
                   <td>${templateUtilities.codeableConceptCoding(sectionCodeableConcept)}</td>
+                  <td>${date ?? ""}</td>
                   <td>${data["Description"] ?? ""}</td>
                   <td>${data["Summary"] ?? ""}</td>
                   <td>${data["Source"] ?? ""}</td>
@@ -4240,92 +4391,156 @@ var FunctionalStatusTemplate = class _FunctionalStatusTemplate {
   }
   /**
    * Internal static implementation that actually generates the narrative
-   * @param resources - FHIR resources array containing Observation resources
+   * @param resources - FHIR resources array containing Condition and ClinicalImpression resources
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
   static generateStaticNarrative(resources, timezone) {
     const templateUtilities = new TemplateUtilities(resources);
-    let html = `<p>This section summarizes key observations and assessments related to the person's functional status and ability to perform daily activities.</p>`;
-    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;
-    });
-    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);
-    });
-    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);
+    let html = `<div>
+      <p>This section summarizes key conditions and assessments related to the person's functional status and ability to perform daily activities.</p>`;
+    let conditionHtml = `
+    <div>
+      <h3>Conditions</h3>
+      <table>
+        <thead>
+          <tr>
+            <th>Problem</th>
+            <th>Code (System)</th>
+            <th>Onset Date</th>
+            <th>Recorded Date</th>
+            <th>Source</th>
+          </tr>
+        </thead>
+        <tbody>`;
+    let clinicalImpressionsHtml = `
+    <div>
+      <h3>Clinical Impressions</h3>
+      <table>
+        <thead>
+          <tr>
+            <th>Name</th>
+            <th>Code (System)</th>
+            <th>Date</th>
+            <th>Description</th>
+            <th>Summary</th>
+            <th>Source</th>
+          </tr>
+        </thead>
+        <tbody>`;
+    const conditions = resources.filter((entry) => entry.resourceType === "Condition").map((entry) => entry);
+    conditions.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;
     });
-    if (functionalObservations.length > 0) {
-      html += `<table><thead><tr><th>Observation</th><th>Value</th><th>Date</th><th>Interpretation</th><th>Comments</th><th>Source</th></tr></thead><tbody>`;
-      for (const obs of functionalObservations) {
-        const observation = obs;
-        const obsName = templateUtilities.codeableConceptDisplay(observation.code);
-        if (obsName?.toLowerCase() === "unknown") {
-          continue;
+    const addedConditions = /* @__PURE__ */ new Set();
+    for (const cond of conditions) {
+      const functionalStatusName = this.getFunctionalStatusNameFromCode(cond.code);
+      const problem = templateUtilities.codeableConceptDisplay(cond.code) || functionalStatusName;
+      const codeAndSystem = templateUtilities.codeableConceptCoding(cond.code);
+      if (!codeAndSystem || !problem || !functionalStatusName || addedConditions.has(functionalStatusName)) {
+        continue;
+      }
+      if (problem?.toLowerCase() === "unknown") {
+        continue;
+      }
+      addedConditions.add(functionalStatusName);
+      let date = cond.onsetDateTime ? templateUtilities.renderTime(cond.onsetDateTime, timezone) : "";
+      if (!date && cond.onsetPeriod?.start) {
+        date = templateUtilities.renderTime(
+          cond.onsetPeriod?.start,
+          timezone
+        );
+        if (cond.onsetPeriod?.end) {
+          date += " - " + templateUtilities.renderTime(cond.onsetPeriod?.end, timezone);
         }
-        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>
-          <td>${templateUtilities.capitalizeFirstLetter(obsName)}</td>
-          <td>${value ?? ""}</td>
+      }
+      conditionHtml += `<tr>
+          <td>${templateUtilities.capitalizeFirstLetter(problem)}</td>
+          <td>${codeAndSystem}</td>
           <td>${date}</td>
-          <td>${interpretation}</td>
-          <td>${comments}</td>
-          <td>${templateUtilities.getOwnerTag(observation)}</td>
+          <td>${templateUtilities.renderTime(cond.recordedDate, timezone)}</td>
+          <td>${templateUtilities.getOwnerTag(cond)}</td>
         </tr>`;
+    }
+    const clinicalImpressions = resources.filter((entry) => entry.resourceType === "ClinicalImpression").map((entry) => entry);
+    clinicalImpressions.sort((a, b) => {
+      const dateA = this.getClinicalImpressionEffectiveDate(a);
+      const dateB = this.getClinicalImpressionEffectiveDate(b);
+      return dateB && dateA ? dateB.getTime() - dateA.getTime() : 0;
+    });
+    const addedClinicalImpressions = /* @__PURE__ */ new Set();
+    for (const impression of clinicalImpressions) {
+      const name = templateUtilities.codeableConceptDisplay(impression.code);
+      const codeAndSystem = templateUtilities.codeableConceptCoding(impression.code);
+      if (!codeAndSystem || addedClinicalImpressions.has(name)) {
+        continue;
       }
-      html += `</tbody></table>`;
-    }
-    if (clinicalImpressions.length > 0) {
-      html += `<table><thead><tr><th>Date</th><th>Status</th><th>Description</th><th>Summary</th><th>Findings</th><th>Source</th></tr></thead><tbody>`;
-      for (const impression of clinicalImpressions) {
-        let formattedDate = "";
-        if (impression.effectiveDateTime) {
-          formattedDate = templateUtilities.renderTime(impression.effectiveDateTime, timezone);
-        } else if (impression.effectivePeriod) {
-          formattedDate = templateUtilities.renderPeriod(impression.effectivePeriod, timezone);
-        } else if (impression.date) {
-          formattedDate = templateUtilities.renderDate(impression.date);
-        }
-        let findingsHtml = "";
-        if (impression.finding && impression.finding.length > 0) {
-          findingsHtml = "<ul>";
-          for (const finding of impression.finding) {
-            const findingText = finding.itemCodeableConcept ? templateUtilities.codeableConceptDisplay(finding.itemCodeableConcept) : finding.itemReference ? templateUtilities.renderReference(finding.itemReference) : "";
-            const cause = finding.basis || "";
-            findingsHtml += `<li>${findingText}${cause ? ` - ${cause}` : ""}</li>`;
-          }
-          findingsHtml += "</ul>";
+      if (!name || name?.toLowerCase() === "unknown") {
+        continue;
+      }
+      addedClinicalImpressions.add(name);
+      let date = impression.effectiveDateTime ? templateUtilities.renderTime(impression.effectiveDateTime, timezone) : "";
+      if (!date && impression.effectivePeriod?.start) {
+        date = templateUtilities.renderTime(
+          impression.effectivePeriod?.start,
+          timezone
+        );
+        if (impression.effectivePeriod?.end) {
+          date += " - " + templateUtilities.renderTime(impression.effectivePeriod?.end, timezone);
         }
-        html += `<tr>
-          <td>${formattedDate}</td>
-          <td>${impression.status || ""}</td>
+      }
+      clinicalImpressionsHtml += `<tr>
+          <td>${templateUtilities.capitalizeFirstLetter(name)}</td>
+          <td>${codeAndSystem}</td>
+          <td>${date}</td>
           <td>${impression.description || ""}</td>
           <td>${impression.summary || ""}</td>
-          <td>${findingsHtml}</td>
           <td>${templateUtilities.getOwnerTag(impression)}</td>
         </tr>`;
+    }
+    if (addedConditions.size > 0) {
+      html += conditionHtml;
+      html += `
+          </tbody>
+        </table>
+        </div>`;
+    }
+    if (addedClinicalImpressions.size > 0) {
+      html += clinicalImpressionsHtml;
+      html += `
+          </tbody>
+        </table>
+        </div>`;
+    }
+    html += `
+    </div>`;
+    return addedConditions.size > 0 || addedClinicalImpressions.size > 0 ? html : void 0;
+  }
+  static getFunctionalStatusNameFromCode(cc) {
+    if (!cc) return "";
+    for (const coding of cc.coding || []) {
+      let functionalStatusName = FUNCTIONAL_STATUS_SNOMED_CODES[coding.code];
+      if (functionalStatusName) {
+        return functionalStatusName;
+      }
+      functionalStatusName = FUNCTIONAL_STATUS_ASSESSMENT_LOINC_CODES[coding.code];
+      if (functionalStatusName) {
+        return functionalStatusName;
       }
-      html += `</tbody></table>`;
     }
-    if (functionalObservations.length === 0 && clinicalImpressions.length === 0) {
-      html += `<p>No functional status information available.</p>`;
+  }
+  static getClinicalImpressionEffectiveDate(impression) {
+    if (impression.effectiveDateTime) {
+      return new Date(impression.effectiveDateTime);
+    } else if (impression.effectivePeriod) {
+      if (impression.effectivePeriod.start) {
+        return new Date(impression.effectivePeriod.start);
+      } else if (impression.effectivePeriod.end) {
+        return new Date(impression.effectivePeriod.end);
+      }
     }
-    return html;
   }
 };
 
@@ -4476,7 +4691,78 @@ var AdvanceDirectivesTemplate = class _AdvanceDirectivesTemplate {
       const dateB = new Date(b.dateTime || 0);
       return dateB.getTime() - dateA.getTime();
     });
-    return _AdvanceDirectivesTemplate.generateStaticNarrative(resources, timezone);
+    return _AdvanceDirectivesTemplate.generateStaticNarrative(
+      resources,
+      timezone
+    );
+  }
+  /**
+   * Generate HTML narrative for advance directives 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 all Consent resources, sorted by date (most recent first).</p>
+`;
+    html += `
+      <div>
+        <table>
+          <thead>
+            <tr>
+              <th>Directive</th>
+              <th>Code (System)</th>
+              <th>Action Controlled</th>
+              <th>Policy Rule</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) {
+            if (columnTitle === "DateTime") {
+              data[columnTitle] = templateUtilities.renderTime(
+                columnData.text?.div ?? "",
+                timezone
+              );
+            } else {
+              data[columnTitle] = templateUtilities.renderTextAsHtml(
+                columnData.text?.div ?? ""
+              );
+            }
+          }
+        }
+        if (data["Advanced Directive Name"]?.toLowerCase() === "unknown") {
+          continue;
+        }
+        isSummaryCreated = true;
+        html += `
+          <tr>
+            <td>${templateUtilities.capitalizeFirstLetter(data["Advanced Directive Name"] ?? "")}</td>
+            <td>${data["codeSystem"] ?? ""}</td>
+            <td>${data["Provision Action"] ?? ""}</td>
+            <td>${data["Policy Rule"] ?? ""}</td>
+            <td>${data["DateTime"] ?? ""}</td>
+            <td>${data["Source"] ?? ""}</td>
+          </tr>`;
+      }
+    }
+    html += `
+          </tbody>
+        </table>
+      </div>`;
+    return isSummaryCreated ? html : void 0;
   }
   /**
    * Internal static implementation that actually generates the narrative
@@ -4484,7 +4770,6 @@ var AdvanceDirectivesTemplate = class _AdvanceDirectivesTemplate {
    * @param timezone - Optional timezone to use for date formatting (e.g., 'America/New_York', 'Europe/London')
    * @returns HTML string for rendering
    */
-  // eslint-disable-next-line @typescript-eslint/no-unused-vars
   static generateStaticNarrative(resources, timezone) {
     const templateUtilities = new TemplateUtilities(resources);
     let html = `<p>This list includes all Consent resources, sorted by date (most recent first).</p>
@@ -4492,35 +4777,57 @@ var AdvanceDirectivesTemplate = class _AdvanceDirectivesTemplate {
     html += `<table>
         <thead>
           <tr>
-            <th>Scope</th>
-            <th>Status</th>
+            <th>Directive</th>
+            <th>Code (System)</th>
             <th>Action Controlled</th>
+            <th>Policy Rule</th>
             <th>Date</th>
             <th>Source</th>
           </tr>
         </thead>
         <tbody>`;
-    let isConsentAdded = false;
+    const consentAdded = /* @__PURE__ */ new Set();
     for (const resourceItem of resources) {
       const consent = resourceItem;
-      const consentScope = templateUtilities.capitalizeFirstLetter(templateUtilities.renderTextAsHtml(templateUtilities.codeableConceptDisplay(consent.scope, "display")));
-      if (!consentScope || consentScope.toLowerCase() === "unknown") {
+      let consentDirective = {};
+      for (const category of consent.category || []) {
+        for (const coding of category.coding || []) {
+          if (coding.system === ADVANCED_DIRECTIVE_CATEGORY_SYSTEM && coding.code && coding.code in ADVANCED_DIRECTIVE_CATEGORY_CODES) {
+            consentDirective = {
+              name: ADVANCED_DIRECTIVE_CATEGORY_CODES[coding.code],
+              system: coding.system,
+              code: coding.code
+            };
+            break;
+          } else if (coding.system === LOINC_SYSTEM && coding.code && coding.code in ADVANCED_DIRECTIVE_LOINC_CODES) {
+            consentDirective = {
+              name: ADVANCED_DIRECTIVE_LOINC_CODES[coding.code],
+              system: coding.system,
+              code: coding.code
+            };
+            break;
+          }
+        }
+      }
+      if (!consentDirective.name || !consentDirective.code || !consentDirective.system || consentDirective.name.toLowerCase() === "unknown" || consentAdded.has(consentDirective.name)) {
         continue;
       }
-      isConsentAdded = true;
+      consentAdded.add(consentDirective.name);
+      const consentCodeSystem = `${consentDirective.code} (${codingSystemDisplayNames_default[consentDirective.system] || consentDirective.system})`;
       html += `
         <tr>
-          <td>${consentScope}</td>
-          <td>${consent.status || ""}</td>
+          <td>${consentDirective.name}</td>
+          <td>${consentCodeSystem || ""}</td>
           <td>${consent.provision?.action ? templateUtilities.concatCodeableConcept(consent.provision.action) : ""}</td>
-          <td>${consent.dateTime || ""}</td>
+          <td>${consent.policyRule ? templateUtilities.formatCodeableConceptValue(consent.policyRule) : ""}</td>
+          <td>${templateUtilities.renderTime(consent.dateTime, timezone) || ""}</td>
           <td>${templateUtilities.getOwnerTag(consent)}</td>
         </tr>`;
     }
     html += `
         </tbody>
       </table>`;
-    return isConsentAdded ? html : void 0;
+    return consentAdded.size > 0 ? html : void 0;
   }
 };