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FhirBundleSdk.create(fhirBundle);\n\n// Access static methods directly on the class\nconst cleaned = FhirBundleSdk.stripNonClinicalData(patient);\n```\n\n## Core Functionality\n\n### 1. Resource Retrieval\n\n#### By ID\n\n```typescript\n// Generic\nconst resource = sdk.getResourceById<Patient>(\"patient-123\");\n\n// Type-specific\nconst patient = sdk.getPatientById(\"patient-123\");\nconst observation = sdk.getObservationById(\"obs-456\");\n```\n\n#### By Type\n\n```typescript\nconst patients = sdk.getPatients();\nconst observations = sdk.getObservations();\nconst encounters = sdk.getEncounters();\nconst conditions = sdk.getConditions();\n```\n\n### 2. Coding System Utilities\n\nAll resources with CodeableConcept fields automatically have enhanced coding utilities for working with standard medical coding systems (LOINC, ICD-10, SNOMED, RxNorm, NDC).\n\n**Important:** Use the specific Smart type aliases (`SmartObservation`, `SmartCondition`, etc.) instead of the generic `Smart<T>` pattern to get full TypeScript support for coding utilities.\n\n```typescript\nimport { SmartObservation, SmartCondition } from \"@metriport/fhir-sdk\";\n\n// ✅ GOOD - Use specific Smart type for full TypeScript support\nconst obs: SmartObservation = sdk.getObservationById(\"obs-123\")!;\n\n// Check if the observation uses LOINC coding\nif (obs.code?.hasLoinc()) {\n  const loincCode = obs.code.getLoincCode(); // Get first LOINC code\n  console.log(\"LOINC code:\", loincCode);\n}\n\n// Check for specific codes\nif (obs.code?.hasLoincCode(\"2339-0\")) {\n  console.log(\"Found glucose measurement!\");\n}\n\n// Work with ICD-10 codes in conditions\nconst condition: SmartCondition = sdk.getConditionById(\"cond-456\")!;\nconst icd10Code = condition.code?.getIcd10Code();\nconst allIcd10 = condition.code?.getIcd10Codes(); // Get all ICD-10 codes\n\n// Check if condition has specific ICD-10 codes\nif (condition.code?.hasSomeIcd10([\"E11.9\", \"E10.9\"])) {\n  console.log(\"Patient has diabetes\");\n}\n\n// Find specific coding with custom logic\nconst diabetesCoding = condition.code?.findIcd10Coding(\n  code => code.startsWith(\"E11\") || code.startsWith(\"E10\")\n);\n```\n\n**Available Coding Systems:**\n\nEach `SmartCodeableConcept` provides methods for these coding systems:\n\n- **LOINC**: `hasLoinc()`, `getLoinc()`, `getLoincCode()`, `getLoincCodes()`, `hasLoincCode()`, `hasSomeLoinc()`, `findLoincCoding()`\n- **ICD-10**: `hasIcd10()`, `getIcd10()`, `getIcd10Code()`, `getIcd10Codes()`, `hasIcd10Code()`, `hasSomeIcd10()`, `findIcd10Coding()`\n- **SNOMED**: `hasSnomed()`, `getSnomed()`, `getSnomedCode()`, `getSnomedCodes()`, `hasSnomedCode()`, `hasSomeSnomed()`, `findSnomedCoding()`\n- **RxNorm**: `hasRxNorm()`, `getRxNorm()`, `getRxNormCode()`, `getRxNormCodes()`, `hasRxNormCode()`, `hasSomeRxNorm()`, `findRxNormCoding()`\n- **NDC**: `hasNdc()`, `getNdc()`, `getNdcCode()`, `getNdcCodes()`, `hasNdcCode()`, `hasSomeNdc()`, `findNdcCoding()`\n\n**Smart Resource Types with Coding Utilities:**\n\n```typescript\nimport {\n  SmartObservation,\n  SmartCondition,\n  SmartProcedure,\n  SmartAllergyIntolerance,\n  SmartEncounter,\n  SmartDiagnosticReport,\n  SmartImmunization,\n  SmartMedication,\n  SmartMedicationRequest,\n  SmartMedicationAdministration,\n  SmartMedicationDispense,\n  SmartMedicationStatement,\n  SmartFamilyMemberHistory,\n  SmartRelatedPerson,\n  SmartRiskAssessment,\n  SmartServiceRequest,\n  SmartCarePlan,\n  SmartPatient,\n  SmartPractitioner,\n  SmartOrganization,\n  SmartLocation,\n  SmartComposition,\n  SmartCoverage,\n  SmartDocumentReference,\n} from \"@metriport/fhir-sdk\";\n```\n\nAll SDK getter methods return the appropriate Smart type automatically:\n\n```typescript\n// These all return the specific Smart types with coding utilities\nconst observations: SmartObservation[] = sdk.getObservations();\nconst conditions: SmartCondition[] = sdk.getConditions();\nconst procedures: SmartProcedure[] = sdk.getProcedures();\n```\n\n### 3. Smart Reference Resolution\n\nResources include typed getter methods for convenient and type-safe reference traversal:\n\n```typescript\nconst observation = sdk.getObservationById(\"obs-123\");\n\n// Direct access to referenced resources\nconst patient = observation.getSubject<Patient>();\n```\n\n**Smart Resource Methods:**\n\nAll smart resources include these utility methods:\n\n**Automatic console.log formatting** - Resources automatically render nicely when printed:\n\n```typescript\nconst patient = sdk.getPatientById(\"patient-123\");\n\n// Just use console.log directly - no need to call toString()!\nconsole.log(patient);\n// Output:\n// {\n//   resourceType: 'Patient',\n//   id: 'patient-123',\n//   name: [ { family: 'Doe', given: [Array] } ],\n//   ...\n// }\n```\n\n**toString()** - Manual formatting with custom spacing:\n\n```typescript\n// Use toString() if you need custom spacing\nconsole.log(patient.toString(4)); // 4 spaces\nconst jsonString = patient.toString(0); // Compact JSON\n```\n\nThis is useful for debugging and inspecting deeply nested structures. The output automatically excludes smart resource methods and shows the raw FHIR resource data.\n\n**getReferencingResources()** - Find all resources that reference this resource:\n\n```typescript\nconst patient = sdk.getPatientById(\"patient-123\");\n\n// Find all resources referencing this patient\nconst references = patient.getReferencingResources();\n\n// Filter by resource type\nconst observations = patient.getReferencingResources({ resourceType: \"Observation\" });\n```\n\n**getReferencedResources()** - Find all resources referenced by this resource:\n\n```typescript\nconst observation = sdk.getObservationById(\"obs-123\");\n\n// Get all resources this observation references\nconst referencedResources = observation.getReferencedResources();\n// Returns: [Patient, Encounter, Practitioner, etc.] based on REFERENCE_METHOD_MAPPING\n\n// SDK-level method also available\nconst refs = sdk.getResourcesReferencedBy(observation);\n```\n\nThis method automatically discovers and returns all resources referenced by the current resource based on the configured reference methods in `REFERENCE_METHOD_MAPPING`. It handles both single references and array references.\n\n### 4. Bundle Export\n\nYou can export subsets of your bundle or export by resource type to quickly create custom bundles.\n\n```typescript\n// Export by resource IDs - great for diff bundles!\nconst subset = sdk.exportSubset([\"patient-uuid-1\", \"obs-uuid-1\"]);\n\n// Export by resource type - great for resource type bundles!\nconst observationBundle = sdk.exportByType(\"Observation\");\n```\n\n### 5. Validation\n\nValidate your bundle to ensure there are no broken references. A broken reference is a reference that points to a resource that does not exist in the bundle.\n\n```typescript\nconst result = sdk.lookForBrokenReferences();\nconsole.log(result.hasBrokenReferences); // true if at least one broken reference is found, false otherwise\nconsole.log(result.brokenReferences); // All broken references in bundle\n```\n\n### 6. Reverse Reference Lookup\n\nFind all resources that reference a given resource (reverse lookup). This is useful for discovering what refers to a specific resource.\n\n```typescript\nconst patient = sdk.getPatientById(\"patient-123\");\n\n// Find all resources that reference this patient\nconst referencingResources = sdk.getResourcesReferencingId(\"patient-123\");\nconsole.log(referencingResources); // [Observation, Encounter, DiagnosticReport, ...]\n\n// Filter by resource type\nconst observations = sdk.getResourcesReferencingId(\"patient-123\", {\n  resourceType: \"Observation\",\n});\n\n// Filter by reference field\nconst subjectReferences = sdk.getResourcesReferencingId(\"patient-123\", {\n  referenceField: \"subject\",\n});\n\n// Use smart resource method\nconst backRefs = patient.getReferencingResources();\nconst encounteredObs = patient.getReferencingResources({\n  resourceType: \"Observation\",\n  referenceField: \"subject\",\n});\n```\n\n**Key Features:**\n\n- **O(1) lookup** - constant time performance\n- **Flexible filtering** - by resource type and/or reference field\n- **Smart resources** - returns fully functional Smart resources\n- **Bi-directional** - complements forward reference navigation\n\n### 7. Date Range Search\n\nSearch for resources by date range using an interval tree index. This is useful for filtering resources by clinical dates efficiently.\n\n```typescript\nconst sdk = await FhirBundleSdk.create(bundle);\n\n// Basic date range search\nconst results = sdk.searchByDateRange({\n  dateFrom: \"2024-01-01\",\n  dateTo: \"2024-01-31\",\n});\n\n// Filter by resource type\nconst observations = sdk.searchByDateRange({\n  dateFrom: \"2024-01-01\",\n  dateTo: \"2024-12-31\",\n  resourceTypes: [\"Observation\", \"Condition\"],\n});\n\n// Filter by specific date field\nconst recordedConditions = sdk.searchByDateRange({\n  dateFrom: \"2024-01-01\",\n  dateTo: \"2024-12-31\",\n  dateFields: [\"recordedDate\"],\n});\n\n// Use Date objects\nconst recentResources = sdk.searchByDateRange({\n  dateFrom: new Date(\"2024-01-01\"),\n  dateTo: new Date(),\n});\n```\n\n**Key Features:**\n\n- **O(log n + k) search** - efficient interval tree-based search where k is the number of matching resources\n- **Multiple date fields** - indexes primary clinical dates (effectiveDateTime, onset, performed) and recorded dates\n- **Flexible filtering** - by resource type and/or specific date fields\n- **Smart resources** - returns fully functional Smart resources\n- **Period support** - handles both single date fields and date periods/ranges\n\n**Indexed Resource Types:**\n\nThe following resource types and date fields are automatically indexed:\n\n- **Observation**: effectiveDateTime, effectivePeriod, effectiveInstant, issued\n- **Condition**: onsetDateTime, onsetPeriod, abatementDateTime, abatementPeriod, recordedDate\n- **Encounter**: period\n- **Procedure**: performedDateTime, performedPeriod\n- **Immunization**: occurrenceDateTime, recorded\n- **DiagnosticReport**: effectiveDateTime, effectivePeriod, issued\n- **MedicationRequest**: authoredOn\n- **MedicationAdministration**: effectiveDateTime, effectivePeriod\n- **MedicationStatement**: effectiveDateTime, effectivePeriod\n- **MedicationDispense**: whenHandedOver, whenPrepared\n- **DocumentReference**: date, context.period\n- **Composition**: date\n- **Coverage**: period\n- **AllergyIntolerance**: onsetDateTime, onsetPeriod, lastOccurrence, recordedDate\n\n### 8. Reference Walking (BFS Traversal)\n\nWalk the reference graph starting from any resource using breadth-first search (BFS). This is useful for discovering all resources connected to a specific resource.\n\n```typescript\nconst observation = sdk.getObservationById(\"obs-123\");\n\n// Walk all reachable resources\nconst result = sdk.walkReferences(observation);\nconsole.log(result.allResources); // All resources reachable from observation\nconsole.log(result.resourcesByDepth); // Resources organized by depth level\nconsole.log(result.depthReached); // Maximum depth traversed\n\n// Limit traversal depth\nconst limitedResult = sdk.walkReferences(observation, { maxDepth: 2 });\n\n// Exclude the start resource from results\nconst withoutStart = sdk.walkReferences(observation, { includeStartResource: false });\n```\n\n### 9. LLM Context Generation\n\nGenerate comprehensive, LLM-friendly context from a resource and its related resources. This automatically performs BFS traversal, strips non-clinical metadata, and formats the output for optimal LLM consumption.\n\n```typescript\nconst observation = sdk.getObservationById(\"obs-123\");\n\n// Generate structured text context (default, best for LLMs)\nconst llmContext = sdk.generateLLMContext(observation, {\n  maxDepth: 2, // Default: 2\n  format: \"structured-text\", // Default: 'structured-text'\n});\n\n// Send to your LLM\nawait llm.chat({\n  messages: [\n    { role: \"system\", content: \"You are a medical data analyst.\" },\n    { role: \"user\", content: `Analyze this patient data:\\n\\n${llmContext}` },\n  ],\n});\n\n// Alternative: JSON format\nconst jsonContext = sdk.generateLLMContext(observation, {\n  format: \"json\",\n});\n```\n\n**Features:**\n\n- Automatically discovers all related resources via BFS traversal\n- Strips non-clinical metadata (`meta`, `extension`, `text`) to reduce tokens by ~30-40%\n- Organizes resources hierarchically (primary → directly referenced → indirectly referenced)\n- Groups resources by type within each depth level\n- Logs resource counts for debugging (not included in output)\n\n**Static Methods:**\n\nThe `FhirBundleSdk` class provides static utility methods that don't require an SDK instance:\n\n```typescript\nimport { FhirBundleSdk } from \"@metriport/fhir-sdk\";\n\n// Strip non-clinical data from any resource\nconst cleanedPatient = FhirBundleSdk.stripNonClinicalData(patient);\n// Removes: meta, extension, modifierExtension, text, id, identifier, and all reference fields\n// Returns immutable copy\n\n// Create SDK instances\nconst sdk = await FhirBundleSdk.create(bundle); // Async (for backwards compatibility)\nconst sdk2 = FhirBundleSdk.createSync(bundle); // Synchronous\n```\n\nThis is especially useful in REPL sessions where you want quick access to utility functions without creating a full SDK instance.\n\n### 10. Type Guards\n\nFilter mixed arrays of FHIR resources to specific types with full TypeScript type safety:\n\n```typescript\nimport { Resource } from \"@medplum/fhirtypes\";\nimport { isPatient, isObservation, isDiagnosticReport } from \"@metriport/fhir-sdk\";\n\n// Filter mixed resource arrays\nconst resources: Resource[] = [\n  { resourceType: \"Patient\", id: \"patient-1\" },\n  { resourceType: \"Observation\", id: \"obs-1\", status: \"final\", code: { text: \"test\" } },\n  { resourceType: \"DiagnosticReport\", id: \"report-1\", status: \"final\", code: { text: \"lab\" } },\n];\n\nconst patients = resources.filter(isPatient); // Patient[]\nconst observations = resources.filter(isObservation); // Observation[]\n\n// TypeScript knows the exact type after filtering\npatients.forEach(patient => {\n  const name = patient.name; // ✅ Type-safe access to Patient fields\n});\n\n// Works with Smart resources too\nconst allObs = sdk.getObservations();\nallObs.forEach(obs => {\n  if (isObservation(obs)) {\n    const subject = obs.getSubject(); // ✅ Smart methods available\n    const status = obs.status; // ✅ Observation fields available\n  }\n});\n```\n\n**Available type guards:**\nUse the `is<ResourceType>` type guard to check if a resource is of a specific type. There is one for every fhir resource type. Use them whenever possible over writing your own type guards.\n\n## Example Use Cases\n\n### Filter by Medical Codes\n\n```typescript\nimport { SmartObservation, SmartCondition } from \"@metriport/fhir-sdk\";\n\n// Find all glucose observations using LOINC codes\nconst glucoseObs = sdk.getObservations().filter(\n  obs =>\n    obs.code?.hasLoincCode(\"2339-0\") || // Glucose [Mass/volume] in Blood\n    obs.code?.hasLoincCode(\"2345-7\") // Glucose [Mass/volume] in Serum or Plasma\n);\n\n// Find all diabetes conditions using ICD-10 codes\nconst diabetesConditions = sdk.getConditions().filter(cond =>\n  cond.code?.findIcd10Coding(\n    code =>\n      code.startsWith(\"E10\") || // Type 1 diabetes\n      code.startsWith(\"E11\") // Type 2 diabetes\n  )\n);\n\n// Find medications by RxNorm code\nconst metforminMeds = sdk\n  .getMedicationRequests()\n  .filter(medReq => medReq.medicationCodeableConcept?.hasRxNormCode(\"6809\"));\n\n// Complex filtering with multiple coding systems\nconst labResults = sdk.getObservations().filter(obs => {\n  if (obs.code?.hasLoinc()) {\n    const loincCode = obs.code.getLoincCode();\n    // Filter for specific lab panels\n    return (\n      loincCode?.startsWith(\"24331\") || // Lipid panel\n      loincCode?.startsWith(\"24362\")\n    ); // Complete blood count\n  }\n  return false;\n});\n```\n\n### Patient Summary\n\n```typescript\nconst buildPatientSummary = (patientId: string) => {\n  const patient = sdk.getPatientById(patientId);\n  const observations = sdk.getObservations().filter(obs => obs.getSubject()?.id === patientId);\n\n  return {\n    name: patient?.name?.[0]?.family,\n    observationCount: observations.length,\n    recentObs: observations.slice(0, 5),\n  };\n};\n```\n\n### Reference Traversal\n\n```typescript\n// Traverse multiple references in sequence\nconst orgName = sdk.getPatients()[0]?.getManagingOrganization()?.name;\n```\n\n### Extract Related Resources\n\n```typescript\n// Get all resources related to a specific observation\nconst extractRelatedResources = (observationId: string) => {\n  const observation = sdk.getObservationById(observationId);\n  if (!observation) return null;\n\n  // Walk the graph to find all related resources up to 2 levels deep\n  const result = sdk.walkReferences(observation, { maxDepth: 2 });\n\n  return {\n    observation,\n    relatedResourceCount: result.allResources.length,\n    resourcesByType: result.allResources.reduce((acc, resource) => {\n      acc[resource.resourceType] = (acc[resource.resourceType] || 0) + 1;\n      return acc;\n    }, {} as Record<string, number>),\n  };\n};\n```\n\n### Example Use Case: Processing a bundle\n\n```typescript\nconst processBundle = async (bundle: Bundle) => {\n  const sdk = await FhirBundleSdk.create(bundle);\n\n  const { hasBrokenReferences, brokenReferences } = sdk.lookForBrokenReferences();\n\n  if (hasBrokenReferences) {\n    throw new MetriportError(\"Broken references found in bundle\", {\n      brokenReferences,\n    });\n  }\n\n  // Process\n  const patients = sdk.getPatients();\n  const summaries = patients.map(p => ({\n    id: p.id,\n    name: p.name?.[0]?.family,\n    obsCount: sdk.getObservations().filter(obs => obs.getSubject()?.id === p.id).length,\n  }));\n\n  return summaries;\n};\n```\n\n## Performance\n\n- **getById**: O(1) lookup\n- **getByType**: O(n) where n = resources of that type\n- **Reference resolution**: O(1) traversal\n- **Reverse reference lookup**: O(1) lookup\n\n## Demo\n\nTo see reverse reference functionality in action, run:\n\n```bash\n# From the utils package\ncd packages/utils\nnpx ts-node src/fhir-sdk/demo-reverse-references.ts --bundle-path /path/to/your/bundle.json\n```\n\nThe demo will:\n\n- Automatically find the first patient in your bundle\n- Showcase all reverse reference capabilities:\n  - Finding all resources that reference a specific resource\n  - Filtering by resource type and reference field\n  - Using smart resource methods\n  - Bi-directional navigation\n  - Performance characteristics\n","readmeFilename":"README.md"}