diff --git a/org.hl7.fhir.r4/src/main/java/org/hl7/fhir/r4/ips/IPSBuilder.java b/org.hl7.fhir.r4/src/main/java/org/hl7/fhir/r4/ips/IPSBuilder.java
new file mode 100644
index 000000000..02dcf5bca
--- /dev/null
+++ b/org.hl7.fhir.r4/src/main/java/org/hl7/fhir/r4/ips/IPSBuilder.java
@@ -0,0 +1,430 @@
+package org.hl7.fhir.r4.ips;
+
+import java.util.Date;
+import java.util.List;
+
+import org.hl7.fhir.r4.ips.IPSBuilder.TypeAndId;
+import org.hl7.fhir.r4.model.Age;
+import org.hl7.fhir.r4.model.Annotation;
+import org.hl7.fhir.r4.model.Bundle;
+import org.hl7.fhir.r4.model.Bundle.BundleEntryComponent;
+import org.hl7.fhir.r4.model.Bundle.BundleType;
+import org.hl7.fhir.r4.model.CodeableConcept;
+import org.hl7.fhir.r4.model.Coding;
+import org.hl7.fhir.r4.model.Composition;
+import org.hl7.fhir.r4.model.Patient;
+import org.hl7.fhir.r4.model.Period;
+import org.hl7.fhir.r4.model.Quantity;
+import org.hl7.fhir.r4.model.Range;
+import org.hl7.fhir.r4.model.Reference;
+import org.hl7.fhir.r4.model.Type;
+import org.hl7.fhir.r4.model.Composition.CompositionStatus;
+import org.hl7.fhir.r4.model.Composition.SectionComponent;
+import org.hl7.fhir.r4.model.Condition;
+import org.hl7.fhir.r4.model.Device;
+import org.hl7.fhir.r4.model.DomainResource;
+import org.hl7.fhir.r4.model.Dosage;
+import org.hl7.fhir.r4.model.Identifier;
+import org.hl7.fhir.r4.model.Medication;
+import org.hl7.fhir.r4.model.MedicationStatement;
+import org.hl7.fhir.r4.model.Narrative.NarrativeStatus;
+import org.hl7.fhir.r4.utils.client.FHIRToolingClient;
+import org.hl7.fhir.utilities.Utilities;
+import org.hl7.fhir.utilities.VersionUtil;
+import org.hl7.fhir.utilities.xhtml.XhtmlNode;
+
+public class IPSBuilder {
+
+  public static class TypeAndId {
+    private String type;
+    private String id;
+    protected TypeAndId(String type, String id) {
+      super();
+      this.type = type;
+      this.id = id;
+    }
+    public String getType() {
+      return type;
+    }
+    public String getId() {
+      return id;
+    }
+  }
+
+  public static Bundle generateIPS(FHIRToolingClient server, String patientId) {
+    Patient pat = server.fetchResource(Patient.class, patientId);
+    Bundle bnd = initBundle();
+    Composition cmp = initComposition(bnd, server.getAddress(), pat);
+    pat = processPatient(bnd, server.getAddress(), pat);
+//    addMedications(bnd, cmp, server, patientId);
+    addConditions(bnd, cmp, server, patientId);
+    return bnd;
+  }
+
+  private static Bundle initBundle() {
+    Bundle bnd = new Bundle();
+    bnd.getIdentifier().setSystem("urn:ietf:rfc:3986");
+    bnd.getIdentifier().setValue(Utilities.makeUuidUrn());
+    bnd.setType(BundleType.DOCUMENT);
+    bnd.setTimestamp(new Date());
+    return bnd;
+  }
+  
+  private static Composition initComposition(Bundle bnd, String url, Patient pat) {
+    Composition cmp = new Composition();
+    cmp.setIdBase(Utilities.makeUuidLC());
+    cmp.setStatus(CompositionStatus.FINAL);
+    cmp.getType().addCoding().setSystem("http://loinc.org").setCode("60591-5");
+    cmp.setDate(new Date());
+    cmp.setTitle("International Patient Summary");
+    cmp.getSubject().setReference("Patient/"+pat.getIdBase());
+    cmp.addAuthor().setReference("Device/java");
+    bnd.addEntry().setResource(cmp).setFullUrl(Utilities.pathURL(url, "Composition", cmp.getIdBase()));
+    Device dev = new Device();
+    dev.setId("java");
+    dev.addDeviceName().setName("Java Core Library");
+    dev.addVersion().setValue(VersionUtil.getVersion());
+    return cmp;
+  }
+
+  private static Patient processPatient(Bundle bnd,  String url, Patient pat) {
+    bnd.addEntry().setResource(pat).setFullUrl(Utilities.pathURL(url, "Patient", pat.getIdBase()));
+    return pat;
+  }
+  
+  private static void addMedications(Bundle bnd, Composition cmp, FHIRToolingClient server, String patientId) {
+    Bundle sb = server.search("MedicationStatement", "?patient="+patientId+"&_include=MedicationStatement:medication&_include=MedicationStatement:source");
+    SectionComponent sct = cmp.addSection();
+    sct.setTitle("Medications");
+    sct.getCode().addCoding().setSystem("http://loinc.org").setCode("10160-0");
+    sct.getText().setStatus(NarrativeStatus.GENERATED);
+    var x = sct.getText().getDiv();
+    var tbl = x.table("grid");
+    var tr = tbl.tr();
+    tr.th().tx("Medication");
+    tr.th().tx("Category");
+    tr.th().tx("Status");
+    tr.th().tx("When");
+    tr.th().tx("Dosage");
+    tr.th().tx("Reason");
+    tr.th().tx("Source");
+    tr.th().tx("Notes");
+
+    boolean ok = false;
+    for (BundleEntryComponent be : sb.getEntry()) {
+      if (be.hasResource() && be.getResource() instanceof MedicationStatement) {
+        MedicationStatement mdstmt = (MedicationStatement) be.getResource();
+        ok = true;
+        bnd.addEntry().setResource(mdstmt).setFullUrl(Utilities.pathURL(server.getAddress(), "MedicationStatement", mdstmt.getIdBase()));
+        sct.addEntry().setReference("MedicationStatement/"+mdstmt.getIdBase());
+        tr = tbl.tr();
+        if (mdstmt.hasMedicationReference()) {
+          Medication med = findMedication(sb, server, mdstmt, mdstmt.getMedicationReference());
+          if (med == null) {
+            tr.td().b().tx("Unknown?");
+          } else {
+            tr.td().tx(summarise(med));
+            bnd.addEntry().setResource(med).setFullUrl(Utilities.pathURL(server.getAddress(), "Medication", med.getIdBase()));
+          }
+        } else {
+          tr.td().tx(genCC(mdstmt.getMedicationCodeableConcept()));
+        }
+        tr.td().tx(genCC(mdstmt.getCategory()));
+        var td = tr.td();
+        td.tx(mdstmt.getStatus().getDisplay());
+        if (mdstmt.hasStatusReason()) {
+          td.tx(" (");
+          td.tx(genCC(mdstmt.getStatusReason()));
+          td.tx(")");
+        }
+        tr.td().tx(genDT(mdstmt.getEffective()));
+        genDosages(tr.td(), mdstmt.getDosage());
+        tr.td().tx(genReference(mdstmt, mdstmt.getInformationSource(), bnd, sb, server));
+        genNotes(tr.td(), mdstmt.getNote());
+      }
+    }
+    if (!ok) {
+      Condition cnd = new Condition();
+      cnd.setId(Utilities.makeUuidLC());
+
+      cnd.getText().setStatus(NarrativeStatus.GENERATED);
+      var rx = cnd.getText().getDiv();
+      rx.tx("No information is provided about the patient's medical problems");
+      tr = tbl.tr();
+      tr.td().colspan(7).tx("No information is provided about the patient's medical problems");
+      cnd.getClinicalStatus().addCoding().setSystem("http://terminology.hl7.org/CodeSystem/condition-clinical").setCode("active").setDisplay("Active");
+      cnd.getCode().addCoding().setSystem("http://hl7.org/fhir/uv/ips/CodeSystem/absent-unknown-uv-ips").setCode("no-problem-info").setDisplay("No information about current problems");
+      cnd.getSubject().setReference("Patient/"+patientId);
+    }
+  }
+
+
+  private static void genDosages(XhtmlNode x, List<Dosage> dosages) {
+    if (dosages == null || dosages.size() == 0) {
+      
+    } else if (dosages.size() == 1) {
+      genDosage(x, dosages.get(0));
+    } else {
+      var ul = x.ul();
+      for (Dosage d : dosages) {
+        genDosage(ul.li(), d);
+      }
+    } 
+  }
+
+  private static void genDosage(XhtmlNode x, Dosage dosage) {
+    x.tx(dosage.getText());
+    if (dosage.hasAsNeeded()) {
+      x.nbsp();
+      if (dosage.hasAsNeededBooleanType()) {
+        if (dosage.getAsNeededBooleanType().booleanValue()) {
+          x.tx(" (as needed)");
+        }
+      } else {
+        x.tx(genDT(dosage.getAsNeeded()));
+      }
+    } else if (dosage.hasTiming()) {
+      x.nbsp();
+      x.tx(genDT(dosage.getTiming()));
+    }
+    if (dosage.hasSite()) {
+      x.tx(". ");
+      x.tx(genDT(dosage.getSite()));
+    }
+    if (dosage.hasRoute()) {
+      x.tx(". ");
+      x.tx(genDT(dosage.getRoute()));
+    }
+  }
+
+  private static Medication findMedication(Bundle sb, FHIRToolingClient server, MedicationStatement mdstmt, Reference ref) {
+    if (ref == null || !ref.hasReference()) {
+      return null;
+    }
+    if (ref.getReference().startsWith("#")) {
+      
+    } else {
+      
+    }
+    return null;
+  }
+
+  private static void addConditions(Bundle bnd, Composition cmp, FHIRToolingClient server, String patientId) {
+    Bundle sb = server.search("Condition", "?patient="+patientId); //+"&_include=MedicationStatement:asserter");
+    SectionComponent sct = cmp.addSection();
+    sct.setTitle("Problems");
+    sct.getCode().addCoding().setSystem("http://loinc.org").setCode("11450-4");
+    sct.getText().setStatus(NarrativeStatus.GENERATED);
+    var x = sct.getText().getDiv();
+    var tbl = x.table("grid");
+    var tr = tbl.tr();
+    tr.th().tx("Code");
+    tr.th().tx("Category");
+    tr.th().tx("Severity");
+    tr.th().tx("Status");
+    tr.th().tx("Onset");
+    tr.th().tx("Abatement");
+    tr.th().tx("Source");
+    tr.th().tx("Notes");
+
+    boolean ok = false;
+    for (BundleEntryComponent be : sb.getEntry()) {
+      if (be.hasResource() && be.getResource() instanceof Condition) {
+        Condition cnd = (Condition) be.getResource();
+        ok = true;
+        bnd.addEntry().setResource(cnd).setFullUrl(Utilities.pathURL(server.getAddress(), "Condition", cnd.getIdBase()));
+        sct.addEntry().setReference("Condition/"+cnd.getIdBase());
+        tr = tbl.tr();
+        tr.td().tx(genCC(cnd.getCode()));
+        tr.td().tx(genCC(cnd.getCategory()));
+        tr.td().tx(genCC(cnd.getSeverity()));
+        tr.td().tx(genStatus(cnd));
+        tr.td().tx(genDT(cnd.getOnset()));
+        tr.td().tx(genDT(cnd.getAbatement()));
+        tr.td().tx(genSource(cnd, bnd, sb, server));
+        genNotes(tr.td(), cnd.getNote());
+
+      }
+    }
+    if (!ok) {
+      Condition cnd = new Condition();
+      cnd.setId(Utilities.makeUuidLC());
+
+      cnd.getText().setStatus(NarrativeStatus.GENERATED);
+      var rx = cnd.getText().getDiv();
+      rx.tx("No information is provided about the patient's medical problems");
+      tr = tbl.tr();
+      tr.td().colspan(7).tx("No information is provided about the patient's medical problems");
+      cnd.getClinicalStatus().addCoding().setSystem("http://terminology.hl7.org/CodeSystem/condition-clinical").setCode("active").setDisplay("Active");
+      cnd.getCode().addCoding().setSystem("http://hl7.org/fhir/uv/ips/CodeSystem/absent-unknown-uv-ips").setCode("no-problem-info").setDisplay("No information about current problems");
+      cnd.getSubject().setReference("Patient/"+patientId);
+    }
+  }
+
+
+  private static String genReference(DomainResource src, Reference ref, Bundle bnd, Bundle search, FHIRToolingClient server) {
+    if (ref == null || ref.isEmpty()) {
+      return null;
+    }
+    boolean contained = false;
+    DomainResource tgt = null;
+    if (ref.hasReference()) {
+      if (ref.getReference().startsWith("#")) {
+        tgt = (DomainResource) src.getContained(ref.getReference());
+        contained = true;
+      } else {
+        TypeAndId tid = getTypeAndId(server.getAddress(), ref.getReference());
+        if (tid != null) {
+          tgt = findInBundle(bnd, Utilities.pathURL(server.getAddress(), tid.getType(), tid.getId()));
+          if (tgt == null) {
+            tgt = findInBundle(search, Utilities.pathURL(server.getAddress(), tid.getType(), tid.getId()));
+            if (tgt == null) {
+              tgt = (DomainResource) server.read(tid.getType(), tid.getId());
+            }
+          } else {
+            contained = true;
+          }
+        }
+      }
+    }
+    if (tgt != null) {
+      if (!contained) {
+        bnd.addEntry().setResource(tgt).setFullUrl(Utilities.pathURL(server.getAddress(), tgt.fhirType(), tgt.getIdBase()));
+      }
+      return summarise(tgt);
+    } else if (ref.hasDisplay()) {
+      return ref.getDisplay();
+    } else if (ref.hasReference()) {
+      return ref.getReference();
+    } else if (ref.hasIdentifier()) {
+      return genIdentifier(ref.getIdentifier());
+    } else {
+      return "unknown";
+    }
+  }
+
+  
+  private static TypeAndId getTypeAndId(String baseUrl, String url) {
+    if (Utilities.noString(url)) {
+      return null;
+    }
+    if (url.startsWith(baseUrl+"/")) {
+      url = url.substring(baseUrl.length()+1);
+    }
+    String[] p = url.split("\\/");
+    if (p.length > 1) {
+      if ("_history".equals(p[p.length-2]) && p.length > 3) {
+        return new TypeAndId(p[p.length-4], p[p.length-3]);
+      } else {
+        return new TypeAndId(p[p.length-2], p[p.length-1]);
+      }
+    }
+    return null;
+  }
+
+  private static DomainResource findInBundle(Bundle bnd, String url) {
+    for (BundleEntryComponent be : bnd.getEntry()) {
+      if (url.equals(be.getFullUrl()) && be.hasResource() && be.getResource() instanceof DomainResource) {
+        return (DomainResource) be.getResource();
+      }
+    }
+    return null;
+  }
+
+  private static String summarise(DomainResource tgt) {
+    // TODO Auto-generated method stub
+    return null;
+  }
+
+  private static String genIdentifier(Identifier id) {
+    return id.getValue();
+  }
+
+  private static void genNotes(XhtmlNode td, List<Annotation> notes) {
+    if (notes.size() > 0) {
+      if (notes.size() == 1) {
+        genNote(td, notes.get(0));
+      } else {
+        var ul = td.ul();
+        for (Annotation a : notes) {
+          genNote(ul.li(), a);
+        }
+      }
+    }
+  }
+
+  private static void genNote(XhtmlNode td, Annotation annotation) {
+    td.tx(annotation.getText());    
+  }
+
+  private static String genSource(Condition cnd, Bundle bnd, Bundle sb, FHIRToolingClient server) {
+    if (cnd.hasAsserter()) {
+      return genReference(cnd, cnd.getAsserter(), bnd, sb, server);
+    } else if (cnd.hasRecorder()) {
+      return genReference(cnd, cnd.getRecorder(), bnd, sb, server);
+    } else {
+      return null;
+    }
+  }
+
+  private static String genDT(Type v) {
+    if (v == null) {
+      return null;
+    }
+    if (v.isPrimitive()) {
+      return v.primitiveValue();
+    }
+    if (v instanceof Age) {
+      return genQty((Age) v);
+    }
+    if (v instanceof Period) {
+      Period p = (Period) v;
+      return genDT(p.getStartElement())+" - "+genDT(p.getStartElement());
+    }
+    if (v instanceof Range) {
+      Range p = (Range) v;
+      return genDT(p.getLow())+" - "+genDT(p.getHigh());
+    }
+    return "not done: "+v.fhirType();
+  }
+
+  private static String genQty(Quantity v) {
+    return v.getValue().toPlainString()+v.getUnit();
+  }
+
+  private static String genStatus(Condition cnd) {
+    if (cnd.hasClinicalStatus() && cnd.hasVerificationStatus()) {
+      return genCC(cnd.getClinicalStatus()) +"/"+genCC(cnd.getVerificationStatus());
+    } else if (cnd.hasClinicalStatus()) {
+      return genCC(cnd.getClinicalStatus());
+    } else if (cnd.hasVerificationStatus()) {
+      return genCC(cnd.getVerificationStatus());      
+    } else {
+      return null;
+    }
+  }
+
+  private static String genCC(List<CodeableConcept> list) {
+    if (list != null && list.size() == 1) {
+      return genCC(list.get(0));
+    } else {
+      return null;
+    }
+  }
+
+  private static String genCC(CodeableConcept code) {
+    if (code.hasText()) {
+      return code.getText();
+    } else if (code.hasCoding()) {
+      Coding c = code.getCodingFirstRep();
+      if (c.hasDisplay()) {
+        return c.getDisplay();
+      } else {
+        return c.getCode();
+      }
+    } else {
+      return null;
+    }
+  }
+
+}