fhir-data-utils-ts 0.3.7 → 0.4.0

package/.codex/skills/govern-fhir-observation-components/SKILL.md

@@ -53,6 +53,17 @@ description: Implement or audit neutral FHIR Observation claim catalogs, vital-s
   copy `Observation.*`, LOINC, UCUM or category strings into portals,
   assistants, tests or snippets.
 - Keep displays separate from `system|code` tokens and local-language text.
+- For repeated vital signs, keep every raw reading as `registered`, require the
+  configured cadence before deriving a `preliminary` mean, and preserve the
+  source links through `Observation.derived-from`.
+- Persist the EventTiming bucket through the canonical
+  `Observation.date-when` claim. Do not infer MORN/EVE from a server time zone.
+- Build one preliminary Composition per explicit local date and IANA time
+  zone. Only authorized confirmation returns a final daily document with a
+  professional attester and final top-level Observations.
+- Keep ledger hashing, individual-index writes, Digital Twin materialization
+  and research eligibility outside this neutral package. A final graph is data
+  state, not authorization for those side effects.
 
 ## Change with TDD
 

package/CHANGELOG.md

@@ -1,5 +1,16 @@
 # Changelog
 
+## 0.4.0 - 2026-09-27
+
+- Add the neutral daily vital-sign document lifecycle: registered raw readings,
+  preliminary three-reading means, MORN/EVE EventTiming, one preliminary daily
+  Composition and explicit professional finalization.
+- Preserve mean provenance through `Observation.derived-from`, validate the
+  local calendar day with an IANA time zone and project Composition status plus
+  section entry references at the FHIR R4 boundary.
+- Add governed UCUM Fahrenheit and avoirdupois-pound input alongside Celsius
+  and kilograms without moving regional UI preferences into shared FHIR data.
+
 ## 0.3.7 - 2026-09-26
 
 - Add claims-first FHIR contracts for Location-linked Encounter care journeys,

package/README.md

@@ -105,6 +105,15 @@ without inventing a new flat-claim family for each scale.
 `Observation.user-selected` provenance flag. Consumers submit its `entries`
 without reconstructing component claims or relationships.
 
+Repeated morning/evening capture uses `buildRepeatedVitalSignAverage`: three
+two-minute raw readings remain `registered`, while their derived arithmetic
+mean is `preliminary`. `buildVitalSignDailyDocument` groups the day's top-level
+Observations under one preliminary Composition; only
+`finalizeVitalSignDailyDocument` returns a final Composition and final
+top-level Observations with a professional attester. Ledger hashing, index
+updates, Digital Twin and research eligibility remain owning-service policy.
+See [Daily vital-sign document lifecycle](docs/VITAL_SIGN_DAILY_DOCUMENT.md).
+
 See [the UHC FHIR utilities migration](docs/UHC_FHIR_UTILS_MIGRATION.md) for the
 reuse/rewrite/retire inventory and the rule for moving frozen contracts without
 changing any `gdc-*` repository.

package/dist/claims/composition-claims.d.ts

@@ -1,4 +1,5 @@
 export declare const CompositionClaim: {
+    readonly Status: "Composition.status";
     readonly Subject: "Composition.subject";
     readonly Section: "Composition.section";
     readonly Author: "Composition.author";

package/dist/claims/composition-claims.js

@@ -1,6 +1,7 @@
 // Copyright 2026 Conéctate Soluciones y Aplicaciones SL under the Apache License, Version 2.0.
 // File: src/models/interoperable-claims/composition-claims.ts
 export const CompositionClaim = {
+    Status: 'Composition.status',
     Subject: 'Composition.subject',
     Section: 'Composition.section',
     Author: 'Composition.author',

package/dist/converters/convert-composition.js

@@ -31,6 +31,7 @@ function alignedAttesterValue(attesters, select) {
 export function compositionFlatToFhirR4(claims) {
     return {
         resourceType: 'Composition',
+        status: claims[CompositionClaim.Status],
         identifier: claims[CompositionClaim.Identifier] ? { value: claims[CompositionClaim.Identifier] } : undefined,
         subject: claims[CompositionClaim.Subject] ? { reference: claims[CompositionClaim.Subject] } : undefined,
         author: claims[CompositionClaim.Author] ? claims[CompositionClaim.Author].split(',').map((reference) => ({ reference: reference.trim() })) : undefined,
@@ -41,7 +42,9 @@ export function compositionFlatToFhirR4(claims) {
         type: claims[CompositionClaim.Type] ? { coding: codingFromValue(claims[CompositionClaim.Type]) } : undefined,
         section: claims[CompositionClaim.Section]
             ? claims[CompositionClaim.Section].split(',').map((value) => ({ code: { coding: codingFromValue(value.trim()) } }))
-            : undefined,
+            : claims[CompositionClaim.Entry]
+                ? [{ entry: claims[CompositionClaim.Entry].split(',').map((reference) => ({ reference: reference.trim() })) }]
+                : undefined,
     };
 }
 export function compositionFhirR4ToFlat(resource) {
@@ -53,7 +56,14 @@ export function compositionFhirR4ToFlat(resource) {
             .map((item) => codingToValue(item?.code?.coding?.[0]))
             .filter((item) => Boolean(item))
         : [];
+    const entryReferences = Array.isArray(resource.section)
+        ? resource.section
+            .flatMap((section) => Array.isArray(section.entry) ? section.entry : [])
+            .map((entry) => referenceToValue(entry))
+            .filter((item) => Boolean(item))
+        : [];
     return {
+        [CompositionClaim.Status]: resource.status,
         [CompositionClaim.Subject]: referenceToValue(resource.subject),
         [CompositionClaim.Section]: sectionValues.length ? sectionValues.join(',') : undefined,
         [CompositionClaim.Author]: referenceListToCsv(resource.author),
@@ -62,7 +72,7 @@ export function compositionFhirR4ToFlat(resource) {
         [CompositionClaim.AttesterTime]: alignedAttesterValue(attesters, (attester) => attester.time),
         [CompositionClaim.Custodian]: referenceToValue(resource.custodian),
         [CompositionClaim.Date]: resource.date,
-        [CompositionClaim.Entry]: undefined,
+        [CompositionClaim.Entry]: entryReferences.length ? entryReferences.join(',') : undefined,
         [CompositionClaim.Type]: codingToValue(resource.type?.coding?.[0]),
         [CompositionClaim.Identifier]: resource.identifier?.value,
         [CompositionClaim.Title]: resource.title,

package/dist/observation-claims.d.ts

@@ -85,6 +85,7 @@ export declare const ObservationClaim: Readonly<{
     readonly Code: "Observation.code";
     readonly Date: "Observation.date";
     readonly Device: "Observation.device";
+    readonly DerivedFrom: "Observation.derived-from";
     readonly Encounter: "Observation.encounter";
     readonly Focus: "Observation.focus";
     readonly HasMember: "Observation.has-member";
@@ -122,6 +123,8 @@ export declare const ObservationClaim: Readonly<{
     readonly ValueString: "Observation.value-string";
     readonly Note: "Observation.note";
     readonly EffectiveDateTime: "Observation.effective-datetime";
+    /** FHIR EventTiming bucket used by recurring morning/evening capture. */
+    readonly DateWhen: "Observation.date-when";
     /** @deprecated Read-only camelCase key from historical persisted rows. */
     readonly EffectiveDateTimeLegacy: "Observation.effectiveDateTime";
     /** Custom provenance flag for an explicitly entered or selected result. */

package/dist/observation-claims.js

@@ -36,6 +36,7 @@ export const ObservationClaim = Object.freeze({
     Code: 'Observation.code',
     Date: 'Observation.date',
     Device: 'Observation.device',
+    DerivedFrom: 'Observation.derived-from',
     Encounter: 'Observation.encounter',
     Focus: 'Observation.focus',
     HasMember: 'Observation.has-member',
@@ -73,6 +74,8 @@ export const ObservationClaim = Object.freeze({
     ValueString: 'Observation.value-string',
     Note: 'Observation.note',
     EffectiveDateTime: 'Observation.effective-datetime',
+    /** FHIR EventTiming bucket used by recurring morning/evening capture. */
+    DateWhen: 'Observation.date-when',
     /** @deprecated Read-only camelCase key from historical persisted rows. */
     EffectiveDateTimeLegacy: 'Observation.effectiveDateTime',
     /** Custom provenance flag for an explicitly entered or selected result. */

package/dist/vital-sign-observations.d.ts

@@ -71,6 +71,12 @@ export declare const VitalSignsUnits: Readonly<{
         display?: string;
         claim: string;
     }>;
+    readonly Fahrenheit: Readonly<{
+        system: string;
+        code: string;
+        display?: string;
+        claim: string;
+    }>;
     readonly Percent: Readonly<{
         system: string;
         code: string;
@@ -83,6 +89,12 @@ export declare const VitalSignsUnits: Readonly<{
         display?: string;
         claim: string;
     }>;
+    readonly Pound: Readonly<{
+        system: string;
+        code: string;
+        display?: string;
+        claim: string;
+    }>;
 }>;
 /** Governed FHIR/LOINC tokens used by every channel that captures vital signs. */
 export declare const VitalSignCode: Readonly<{
@@ -99,19 +111,24 @@ export declare const VitalSignCode: Readonly<{
 export declare const VitalSignUnit: Readonly<{
     readonly bloodPressure: string;
     readonly temperature: string;
+    readonly temperatureFahrenheit: string;
     readonly heartRate: string;
     readonly oxygenSaturation: string;
     readonly respiratoryRate: string;
     readonly bodyWeight: string;
+    readonly bodyWeightPound: string;
 }>;
+export type VitalSignQuantityUnit = typeof VitalSignUnit[keyof typeof VitalSignUnit];
 export type VitalSignKind = 'blood-pressure' | 'temperature' | 'heart-rate' | 'oxygen-saturation' | 'respiratory-rate' | 'body-weight';
-export type VitalSignObservationStatus = 'preliminary' | 'final';
+export type VitalSignObservationStatus = 'registered' | 'preliminary' | 'final';
+export type VitalSignEventTiming = 'MORN' | 'AFT' | 'EVE' | 'NIGHT';
 type CommonMeasurement = Readonly<{
     entryId: string;
     subjectReference: string;
     kind: VitalSignKind;
     measuredAt: string;
     status: VitalSignObservationStatus;
+    eventTiming?: VitalSignEventTiming;
     deviceReference?: string;
     note?: string;
     userSelected?: boolean;
@@ -123,6 +140,7 @@ export type VitalSignMeasurement = CommonMeasurement & (Readonly<{
 }> | Readonly<{
     kind: Exclude<VitalSignKind, 'blood-pressure'>;
     value: number;
+    unit?: VitalSignQuantityUnit;
 }>);
 /**
  * Canonical claims-first representation of one native FHIR Observation.
@@ -218,6 +236,7 @@ export type VitalSignDeviceReading = Readonly<{
     kind: Exclude<VitalSignKind, 'blood-pressure'>;
     measuredAt: string;
     value: number;
+    unit?: VitalSignQuantityUnit;
     note?: string;
 }>;
 /** Converts a device/API batch to independent preliminary Observations without aggregation. */
@@ -226,6 +245,61 @@ export declare function normalizeVitalSignDeviceBatch(input: Readonly<{
     deviceReference: string;
     readings: readonly VitalSignDeviceReading[];
 }>): readonly VitalSignObservationGraph[];
+export type RepeatedVitalSignReading = Readonly<{
+    entryId: string;
+    measuredAt: string;
+    systolic: number;
+    diastolic: number;
+    note?: string;
+}> | Readonly<{
+    entryId: string;
+    measuredAt: string;
+    value: number;
+    unit?: VitalSignQuantityUnit;
+    note?: string;
+}>;
+export type RepeatedVitalSignSession = Readonly<{
+    eventTiming: VitalSignEventTiming;
+    sourceGraphs: readonly VitalSignObservationGraph[];
+    averageGraph: VitalSignObservationGraph;
+    entries: readonly FlatClaimResourceEntry[];
+}>;
+/**
+ * Converts exactly three readings taken two minutes apart into registered raw
+ * evidence plus one preliminary arithmetic mean. Confirmation belongs to the
+ * daily document boundary; this helper never invents an attester.
+ */
+export declare function buildRepeatedVitalSignAverage(input: Readonly<{
+    entryId: string;
+    subjectReference: string;
+    deviceReference?: string;
+    kind: VitalSignKind;
+    eventTiming: VitalSignEventTiming;
+    readings: readonly RepeatedVitalSignReading[];
+}>): RepeatedVitalSignSession;
+export type VitalSignDailyDocument = Readonly<{
+    localDate: string;
+    timeZone: string;
+    status: 'preliminary' | 'final';
+    composition: FlatClaimResourceEntry;
+    observations: readonly VitalSignObservationGraph[];
+    entries: readonly FlatClaimResourceEntry[];
+}>;
+/** Builds one daily FHIR document graph; hashing, indexing and research remain service policy. */
+export declare function buildVitalSignDailyDocument(input: Readonly<{
+    entryId: string;
+    identifier: string;
+    subjectReference: string;
+    authorReference: string;
+    localDate: string;
+    timeZone: string;
+    observationGraphs: readonly VitalSignObservationGraph[];
+}>): VitalSignDailyDocument;
+/** Confirms a preliminary daily document and finalizes its top-level Observations atomically in memory. */
+export declare function finalizeVitalSignDailyDocument(draft: VitalSignDailyDocument, confirmation: Readonly<{
+    attesterReference: string;
+    confirmedAt: string;
+}>): VitalSignDailyDocument;
 /** Reusable neutral fixtures; consumers and tests must not duplicate wire examples. */
 export declare const VITAL_SIGN_EXAMPLES: Readonly<{
     subjectReference: "Patient/example-subject";

package/dist/vital-sign-observations.js

@@ -1,4 +1,5 @@
 import { buildFlatClaimResourceEntry } from './flat-claim-resource-graph.js';
+import { CompositionAttesterModes, CompositionClaim } from './claims/composition-claims.js';
 import { FhirCodeSystem, ObservationCategoryCodes, ObservationClaim, decodeObservationClaimList, } from './observation-claims.js';
 export { ObservationCategoryCodes, ObservationClaim } from './observation-claims.js';
 function defineCoding(system, code, display) {
@@ -20,8 +21,10 @@ export const VitalSignsUnits = Object.freeze({
     BeatsPerMinute: defineCoding(FhirCodeSystem.Ucum, '/min', 'beats/minute'),
     MillimeterOfMercury: defineCoding(FhirCodeSystem.Ucum, 'mm[Hg]', 'mmHg'),
     Celsius: defineCoding(FhirCodeSystem.Ucum, 'Cel', 'degrees Celsius'),
+    Fahrenheit: defineCoding(FhirCodeSystem.Ucum, '[degF]', 'degrees Fahrenheit'),
     Percent: defineCoding(FhirCodeSystem.Ucum, '%', 'percent'),
     Kilogram: defineCoding(FhirCodeSystem.Ucum, 'kg', 'kilogram'),
+    Pound: defineCoding(FhirCodeSystem.Ucum, '[lb_av]', 'pound'),
 });
 /** Governed FHIR/LOINC tokens used by every channel that captures vital signs. */
 export const VitalSignCode = Object.freeze({
@@ -38,10 +41,12 @@ export const VitalSignCode = Object.freeze({
 export const VitalSignUnit = Object.freeze({
     bloodPressure: VitalSignsUnits.MillimeterOfMercury.claim,
     temperature: VitalSignsUnits.Celsius.claim,
+    temperatureFahrenheit: VitalSignsUnits.Fahrenheit.claim,
     heartRate: VitalSignsUnits.BeatsPerMinute.claim,
     oxygenSaturation: VitalSignsUnits.Percent.claim,
     respiratoryRate: VitalSignsUnits.BeatsPerMinute.claim,
     bodyWeight: VitalSignsUnits.Kilogram.claim,
+    bodyWeightPound: VitalSignsUnits.Pound.claim,
 });
 /**
  * Builds one timestamped Observation. The device is retained as source; this
@@ -58,6 +63,8 @@ export function buildVitalSignObservation(input) {
     };
     if (input.deviceReference)
         claims[ObservationClaim.Device] = required(input.deviceReference, 'vital_sign_device_required');
+    if (input.eventTiming)
+        claims[ObservationClaim.DateWhen] = normalizeEventTiming(input.eventTiming);
     if (input.note?.trim())
         claims[ObservationClaim.Note] = input.note.trim();
     if (input.userSelected !== undefined)
@@ -79,7 +86,7 @@ export function buildVitalSignObservation(input) {
     else {
         if (!validPositive(input.value))
             throw new TypeError('vital_sign_value_invalid');
-        const scalar = scalarDefinition(input.kind);
+        const scalar = scalarDefinition(input.kind, input.unit);
         claims[ObservationClaim.Code] = scalar.coding.claim;
         if (scalar.coding.display)
             claims[ObservationClaim.CodeDisplay] = scalar.coding.display;
@@ -213,6 +220,123 @@ export function normalizeVitalSignDeviceBatch(input) {
         });
     }));
 }
+/**
+ * Converts exactly three readings taken two minutes apart into registered raw
+ * evidence plus one preliminary arithmetic mean. Confirmation belongs to the
+ * daily document boundary; this helper never invents an attester.
+ */
+export function buildRepeatedVitalSignAverage(input) {
+    if (input.readings.length !== 3)
+        throw new TypeError('vital_sign_repeated_reading_count_invalid');
+    const instants = input.readings.map(reading => normalizeDateTime(reading.measuredAt));
+    for (let index = 1; index < instants.length; index += 1) {
+        if (Date.parse(instants[index]) - Date.parse(instants[index - 1]) !== 120_000) {
+            throw new TypeError('vital_sign_repeated_reading_cadence_invalid');
+        }
+    }
+    const eventTiming = normalizeEventTiming(input.eventTiming);
+    const sourceGraphs = Object.freeze(input.readings.map(reading => buildVitalSignObservation({
+        ...reading,
+        subjectReference: input.subjectReference,
+        ...(input.deviceReference ? { deviceReference: input.deviceReference } : {}),
+        kind: input.kind,
+        status: 'registered',
+        eventTiming,
+    })));
+    const common = {
+        entryId: input.entryId,
+        subjectReference: input.subjectReference,
+        ...(input.deviceReference ? { deviceReference: input.deviceReference } : {}),
+        kind: input.kind,
+        measuredAt: instants[1],
+        status: 'preliminary',
+        eventTiming,
+        ...(input.kind === 'blood-pressure' ? {} : { unit: repeatedScalarUnit(input.kind, input.readings) }),
+    };
+    const average = input.kind === 'blood-pressure'
+        ? buildVitalSignObservation({
+            ...common,
+            kind: 'blood-pressure',
+            systolic: mean(input.readings.map(reading => bloodPressureValue(reading, 'systolic'))),
+            diastolic: mean(input.readings.map(reading => bloodPressureValue(reading, 'diastolic'))),
+        })
+        : buildVitalSignObservation({
+            ...common,
+            kind: input.kind,
+            value: mean(input.readings.map(scalarReadingValue)),
+        });
+    const derivedFrom = sourceGraphs.map(graph => graph.primary.reference).join(',');
+    const averageGraph = replacePrimaryClaims(average, {
+        ...average.primary.claims,
+        [ObservationClaim.DerivedFrom]: derivedFrom,
+    });
+    return Object.freeze({
+        eventTiming,
+        sourceGraphs,
+        averageGraph,
+        entries: Object.freeze([...sourceGraphs.flatMap(graph => graph.entries), ...averageGraph.entries]),
+    });
+}
+/** Builds one daily FHIR document graph; hashing, indexing and research remain service policy. */
+export function buildVitalSignDailyDocument(input) {
+    const localDate = normalizeLocalDate(input.localDate);
+    const timeZone = normalizeTimeZone(input.timeZone);
+    if (!input.observationGraphs.length)
+        throw new TypeError('vital_sign_daily_observations_required');
+    const seen = new Set();
+    for (const graph of input.observationGraphs) {
+        if (graph.primary.claims[ObservationClaim.Subject] !== input.subjectReference)
+            throw new TypeError('vital_sign_daily_subject_mismatch');
+        const measuredAt = required(graph.primary.claims[ObservationClaim.EffectiveDateTime] ?? '', 'vital_sign_measured_at_required');
+        if (localDateAt(measuredAt, timeZone) !== localDate)
+            throw new TypeError('vital_sign_daily_local_date_mismatch');
+        for (const entry of graph.entries) {
+            if (seen.has(entry.reference))
+                throw new TypeError('vital_sign_daily_entry_duplicate');
+            seen.add(entry.reference);
+        }
+    }
+    const observationReferences = input.observationGraphs.map(graph => graph.primary.reference);
+    const composition = buildFlatClaimResourceEntry({
+        entryId: input.entryId,
+        resourceType: 'Composition',
+        claims: {
+            [CompositionClaim.Identifier]: required(input.identifier, 'vital_sign_daily_identifier_required'),
+            [CompositionClaim.Status]: 'preliminary',
+            [CompositionClaim.Subject]: required(input.subjectReference, 'vital_sign_subject_required'),
+            [CompositionClaim.Author]: required(input.authorReference, 'vital_sign_daily_author_required'),
+            [CompositionClaim.Date]: latestEffectiveDateTime(input.observationGraphs),
+            [CompositionClaim.Type]: `${FhirCodeSystem.Loinc}|8716-3`,
+            [CompositionClaim.Title]: `Daily vital signs ${localDate}`,
+            [CompositionClaim.Entry]: observationReferences.join(','),
+        },
+    });
+    return freezeDailyDocument(localDate, timeZone, 'preliminary', composition, input.observationGraphs);
+}
+/** Confirms a preliminary daily document and finalizes its top-level Observations atomically in memory. */
+export function finalizeVitalSignDailyDocument(draft, confirmation) {
+    if (draft.status !== 'preliminary' || draft.composition.claims[CompositionClaim.Status] !== 'preliminary') {
+        throw new TypeError('vital_sign_daily_preliminary_required');
+    }
+    const confirmedAt = normalizeDateTime(confirmation.confirmedAt);
+    const attesterReference = required(confirmation.attesterReference, 'vital_sign_daily_attester_required');
+    const observations = Object.freeze(draft.observations.map(graph => replacePrimaryClaims(graph, {
+        ...graph.primary.claims,
+        [ObservationClaim.Status]: 'final',
+    })));
+    const composition = buildFlatClaimResourceEntry({
+        entryId: draft.composition.entryId,
+        resourceType: 'Composition',
+        claims: {
+            ...draft.composition.claims,
+            [CompositionClaim.Status]: 'final',
+            [CompositionClaim.Attester]: attesterReference,
+            [CompositionClaim.AttesterMode]: CompositionAttesterModes.Professional,
+            [CompositionClaim.AttesterTime]: confirmedAt,
+        },
+    });
+    return freezeDailyDocument(draft.localDate, draft.timeZone, 'final', composition, observations);
+}
 function buildBloodPressureComponent(input, role, value, coding) {
     const entryId = `${required(input.entryId, 'vital_sign_entry_id_required')}-${role}`;
     const claims = {
@@ -228,6 +352,8 @@ function buildBloodPressureComponent(input, role, value, coding) {
         claims[ObservationClaim.CodeDisplay] = coding.display;
     if (input.deviceReference)
         claims[ObservationClaim.Device] = required(input.deviceReference, 'vital_sign_device_required');
+    if (input.eventTiming)
+        claims[ObservationClaim.DateWhen] = normalizeEventTiming(input.eventTiming);
     return buildFlatClaimResourceEntry({ entryId, resourceType: 'Observation', claims });
 }
 function freezeObservationGraph(primary, components) {
@@ -248,14 +374,20 @@ function componentQuantityFromEntry(entry) {
     const display = entry.claims[ObservationClaim.CodeDisplay];
     return Object.freeze({ code, ...(display ? { display } : {}), value, unit });
 }
-function scalarDefinition(kind) {
-    switch (kind) {
-        case 'temperature': return { coding: VitalSignsCodes.BodyTemperature, unit: VitalSignUnit.temperature };
-        case 'heart-rate': return { coding: VitalSignsCodes.HeartRate, unit: VitalSignUnit.heartRate };
-        case 'oxygen-saturation': return { coding: VitalSignsCodes.OxygenSaturation, unit: VitalSignUnit.oxygenSaturation };
-        case 'respiratory-rate': return { coding: VitalSignsCodes.RespiratoryRate, unit: VitalSignUnit.respiratoryRate };
-        case 'body-weight': return { coding: VitalSignsCodes.BodyWeight, unit: VitalSignUnit.bodyWeight };
-    }
+function scalarDefinition(kind, requestedUnit) {
+    const definition = (() => {
+        switch (kind) {
+            case 'temperature': return { coding: VitalSignsCodes.BodyTemperature, units: [VitalSignUnit.temperature, VitalSignUnit.temperatureFahrenheit] };
+            case 'heart-rate': return { coding: VitalSignsCodes.HeartRate, units: [VitalSignUnit.heartRate] };
+            case 'oxygen-saturation': return { coding: VitalSignsCodes.OxygenSaturation, units: [VitalSignUnit.oxygenSaturation] };
+            case 'respiratory-rate': return { coding: VitalSignsCodes.RespiratoryRate, units: [VitalSignUnit.respiratoryRate] };
+            case 'body-weight': return { coding: VitalSignsCodes.BodyWeight, units: [VitalSignUnit.bodyWeight, VitalSignUnit.bodyWeightPound] };
+        }
+    })();
+    const unit = requestedUnit ?? definition.units[0];
+    if (!definition.units.includes(unit))
+        throw new TypeError('vital_sign_unit_invalid');
+    return { coding: definition.coding, unit };
 }
 function normalizeDateTime(value) {
     const date = new Date(value);
@@ -263,6 +395,90 @@ function normalizeDateTime(value) {
         throw new TypeError('vital_sign_measured_at_invalid');
     return date.toISOString();
 }
+function normalizeEventTiming(value) {
+    if (value === 'MORN' || value === 'AFT' || value === 'EVE' || value === 'NIGHT')
+        return value;
+    throw new TypeError('vital_sign_event_timing_invalid');
+}
+function mean(values) {
+    if (values.length === 0 || values.some(value => !validPositive(value)))
+        throw new TypeError('vital_sign_value_invalid');
+    return Math.round((values.reduce((total, value) => total + value, 0) / values.length) * 10) / 10;
+}
+function bloodPressureValue(reading, key) {
+    if (!('systolic' in reading) || !('diastolic' in reading))
+        throw new TypeError('blood_pressure_values_invalid');
+    const value = key === 'systolic' ? reading.systolic : reading.diastolic;
+    if (typeof value !== 'number')
+        throw new TypeError('blood_pressure_values_invalid');
+    return value;
+}
+function scalarReadingValue(reading) {
+    if (!('value' in reading) || typeof reading.value !== 'number')
+        throw new TypeError('vital_sign_value_invalid');
+    return reading.value;
+}
+function repeatedScalarUnit(kind, readings) {
+    const units = readings.map(reading => 'unit' in reading ? reading.unit : undefined);
+    const selected = units.find((unit) => Boolean(unit));
+    if (units.some(unit => unit !== undefined && unit !== selected))
+        throw new TypeError('vital_sign_repeated_unit_mismatch');
+    return scalarDefinition(kind, selected).unit;
+}
+function replacePrimaryClaims(graph, claims) {
+    const primary = buildFlatClaimResourceEntry({
+        entryId: graph.primary.entryId,
+        resourceType: 'Observation',
+        claims,
+    });
+    return freezeObservationGraph(primary, graph.components);
+}
+function freezeDailyDocument(localDate, timeZone, status, composition, observations) {
+    const frozenObservations = Object.freeze([...observations]);
+    return Object.freeze({
+        localDate,
+        timeZone,
+        status,
+        composition,
+        observations: frozenObservations,
+        entries: Object.freeze([composition, ...frozenObservations.flatMap(graph => graph.entries)]),
+    });
+}
+function normalizeLocalDate(value) {
+    const normalized = value.trim();
+    if (!/^\d{4}-\d{2}-\d{2}$/.test(normalized))
+        throw new TypeError('vital_sign_daily_local_date_invalid');
+    const parsed = new Date(`${normalized}T00:00:00.000Z`);
+    if (Number.isNaN(parsed.valueOf()) || parsed.toISOString().slice(0, 10) !== normalized) {
+        throw new TypeError('vital_sign_daily_local_date_invalid');
+    }
+    return normalized;
+}
+function normalizeTimeZone(value) {
+    const normalized = value.trim();
+    if (!normalized)
+        throw new TypeError('vital_sign_daily_time_zone_invalid');
+    try {
+        new Intl.DateTimeFormat('en', { timeZone: normalized }).format(0);
+    }
+    catch {
+        throw new TypeError('vital_sign_daily_time_zone_invalid');
+    }
+    return normalized;
+}
+function localDateAt(dateTime, timeZone) {
+    const parts = new Intl.DateTimeFormat('en-CA', {
+        timeZone,
+        year: 'numeric',
+        month: '2-digit',
+        day: '2-digit',
+    }).formatToParts(new Date(dateTime));
+    const value = Object.fromEntries(parts.map(part => [part.type, part.value]));
+    return `${value.year}-${value.month}-${value.day}`;
+}
+function latestEffectiveDateTime(graphs) {
+    return graphs.map(graph => required(graph.primary.claims[ObservationClaim.EffectiveDateTime] ?? '', 'vital_sign_measured_at_required')).sort().at(-1);
+}
 function validPositive(value) {
     return Number.isFinite(value) && value > 0;
 }

package/docs/VITAL_SIGN_DAILY_DOCUMENT.md

@@ -0,0 +1,79 @@
+# Daily vital-sign document lifecycle
+
+This package owns the product-neutral FHIR data contract used by web portals,
+telephone assistants, chatbots and device importers. It does not decide who
+may attest, write an index, anchor a hash on a ledger or contribute data to a
+research study.
+
+## Repeated readings
+
+`buildRepeatedVitalSignAverage(...)` requires exactly three readings separated
+by two minutes. It returns:
+
+- three raw `Observation` graphs with `status=registered`;
+- one arithmetic-mean `Observation` with `status=preliminary`;
+- `Observation.date-when=MORN|AFT|EVE|NIGHT` on raw and mean observations;
+- `Observation.derived-from` references from the mean to all raw observations.
+
+Blood pressure remains one native Observation with systolic and diastolic
+components. Its flat representation keeps the established primary
+`Observation.has-member` graph. No `bp-*`, `component-*`, containment or split
+coding claims are written.
+
+```ts
+const morningBloodPressure = buildRepeatedVitalSignAverage({
+  entryId: averageObservationId,
+  subjectReference,
+  deviceReference,
+  kind: 'blood-pressure',
+  eventTiming: 'MORN',
+  readings: threeTimestampedReadings,
+})
+```
+
+Temperature accepts governed UCUM Celsius or Fahrenheit units. Body weight
+accepts governed UCUM kilograms or avoirdupois pounds. A UI selects one of the
+exported `VitalSignUnit` constants; it never assembles a UCUM token itself.
+
+## One document per local day
+
+`buildVitalSignDailyDocument(...)` validates every Observation against an
+explicit IANA time zone and local calendar date. It returns one preliminary
+`Composition` followed by every Observation graph entry. The Composition
+references only the top-level Observations through `Composition.entry`; reduced
+blood-pressure members remain reachable through `Observation.has-member`.
+
+```ts
+const dailyDraft = buildVitalSignDailyDocument({
+  entryId: dailyCompositionId,
+  identifier: dailyDocumentIdentifier,
+  subjectReference,
+  authorReference,
+  localDate,
+  timeZone,
+  observationGraphs: [
+    ...morningBloodPressure.sourceGraphs,
+    morningBloodPressure.averageGraph,
+  ],
+})
+```
+
+The draft is readable as preliminary clinical work. It is not final evidence
+and this package does not make it eligible for an individual index, Digital
+Twin or research projection.
+
+`finalizeVitalSignDailyDocument(...)` requires a preliminary document, records
+the professional attester and confirmation time, and returns a new immutable
+graph with the Composition and all top-level Observations set to `final`.
+
+```ts
+const finalDailyDocument = finalizeVitalSignDailyDocument(dailyDraft, {
+  attesterReference,
+  confirmedAt,
+})
+```
+
+The owning service may now serialize and hash this one daily document graph.
+Index, ledger and research writes remain separate policy-controlled operations;
+failure in one must not silently claim success in another.
+

package/package.json

@@ -1,6 +1,6 @@
 {
   "name": "fhir-data-utils-ts",
-  "version": "0.3.7",
+  "version": "0.4.0",
   "description": "FHIR-version-neutral flat-claim and SearchParameter data utilities",
   "license": "Apache-2.0",
   "type": "module",