feat(assessments): layered clinical assessment engine end-to-end

Add a template-driven assessment system with universal intake, clinical
pathways, disease instruments (stroke MVP + extended, diabetes, and ten
specialty packs), scoring, patient outcome trends, REST/API + FHIR
export, and Enterprise org-level assessment analytics. Seed packs and
design/licensing docs ship for deploy and pre-GA review.

database/data/pathways/asthma.json

@@ -0,0 +1,32 @@
+{
+  "pathway": {
+    "code": "asthma",
+    "name": "Asthma",
+    "description": "Asthma clinical pathway.",
+    "match_rules": {
+      "icd_prefixes": [
+        "J45"
+      ],
+      "keywords": [
+        "asthma",
+        "asthmatic"
+      ],
+      "exclude_keywords": [
+        "family history"
+      ]
+    },
+    "is_active": true,
+    "sort_order": 60,
+    "meta": {
+      "specialty": "respiratory"
+    }
+  },
+  "templates": [
+    {
+      "template_code": "asthma_core",
+      "is_required_on_activation": true,
+      "phase": "any",
+      "sort_order": 1
+    }
+  ]
+}

database/data/pathways/cancer.json

@@ -0,0 +1,36 @@
+{
+  "pathway": {
+    "code": "cancer",
+    "name": "Cancer",
+    "description": "Cancer clinical pathway.",
+    "match_rules": {
+      "icd_prefixes": [
+        "C"
+      ],
+      "keywords": [
+        "cancer",
+        "carcinoma",
+        "malignancy",
+        "malignant neoplasm",
+        "tumour",
+        "tumor"
+      ],
+      "exclude_keywords": [
+        "family history"
+      ]
+    },
+    "is_active": true,
+    "sort_order": 100,
+    "meta": {
+      "specialty": "oncology"
+    }
+  },
+  "templates": [
+    {
+      "template_code": "cancer_core",
+      "is_required_on_activation": true,
+      "phase": "any",
+      "sort_order": 1
+    }
+  ]
+}

database/data/pathways/ckd.json

@@ -0,0 +1,36 @@
+{
+  "pathway": {
+    "code": "ckd",
+    "name": "CKD",
+    "description": "CKD clinical pathway.",
+    "match_rules": {
+      "icd_prefixes": [
+        "N18",
+        "N19"
+      ],
+      "keywords": [
+        "ckd",
+        "chronic kidney",
+        "chronic renal",
+        "end stage renal",
+        "esrd"
+      ],
+      "exclude_keywords": [
+        "family history"
+      ]
+    },
+    "is_active": true,
+    "sort_order": 40,
+    "meta": {
+      "specialty": "nephrology"
+    }
+  },
+  "templates": [
+    {
+      "template_code": "ckd_core",
+      "is_required_on_activation": true,
+      "phase": "any",
+      "sort_order": 1
+    }
+  ]
+}

database/data/pathways/copd.json

@@ -0,0 +1,34 @@
+{
+  "pathway": {
+    "code": "copd",
+    "name": "COPD",
+    "description": "COPD clinical pathway.",
+    "match_rules": {
+      "icd_prefixes": [
+        "J44"
+      ],
+      "keywords": [
+        "copd",
+        "chronic obstructive",
+        "emphysema",
+        "chronic bronchitis"
+      ],
+      "exclude_keywords": [
+        "family history"
+      ]
+    },
+    "is_active": true,
+    "sort_order": 70,
+    "meta": {
+      "specialty": "respiratory"
+    }
+  },
+  "templates": [
+    {
+      "template_code": "copd_core",
+      "is_required_on_activation": true,
+      "phase": "any",
+      "sort_order": 1
+    }
+  ]
+}

database/data/pathways/dementia.json

@@ -0,0 +1,38 @@
+{
+  "pathway": {
+    "code": "dementia",
+    "name": "Dementia",
+    "description": "Dementia clinical pathway.",
+    "match_rules": {
+      "icd_prefixes": [
+        "F00",
+        "F01",
+        "F02",
+        "F03",
+        "G30"
+      ],
+      "keywords": [
+        "dementia",
+        "alzheimer",
+        "alzheimers",
+        "vascular dementia"
+      ],
+      "exclude_keywords": [
+        "family history"
+      ]
+    },
+    "is_active": true,
+    "sort_order": 80,
+    "meta": {
+      "specialty": "neurology"
+    }
+  },
+  "templates": [
+    {
+      "template_code": "dementia_core",
+      "is_required_on_activation": true,
+      "phase": "any",
+      "sort_order": 1
+    }
+  ]
+}

database/data/pathways/diabetes.json

@@ -0,0 +1,36 @@
+{
+  "pathway": {
+    "code": "diabetes",
+    "name": "Diabetes",
+    "description": "Diabetes mellitus clinical pathway for structured review assessments.",
+    "match_rules": {
+      "icd_prefixes": ["E10", "E11", "E12", "E13", "E14"],
+      "keywords": [
+        "diabetes",
+        "diabetic",
+        "type 1 diabetes",
+        "type 2 diabetes",
+        "dm",
+        "iddm",
+        "niddm",
+        "hyperglycaemia",
+        "hyperglycemia"
+      ],
+      "exclude_keywords": ["family history", "gestational diabetes risk"]
+    },
+    "is_active": true,
+    "sort_order": 20,
+    "meta": {
+      "specialty": "endocrinology",
+      "color": "amber"
+    }
+  },
+  "templates": [
+    {
+      "template_code": "diabetes_core",
+      "is_required_on_activation": true,
+      "phase": "any",
+      "sort_order": 1
+    }
+  ]
+}

database/data/pathways/heart_failure.json

@@ -0,0 +1,37 @@
+{
+  "pathway": {
+    "code": "heart_failure",
+    "name": "Heart Failure",
+    "description": "Heart Failure clinical pathway.",
+    "match_rules": {
+      "icd_prefixes": [
+        "I50",
+        "I11"
+      ],
+      "keywords": [
+        "heart failure",
+        "chf",
+        "ccf",
+        "hfrEF",
+        "hfpef",
+        "congestive cardiac failure"
+      ],
+      "exclude_keywords": [
+        "family history"
+      ]
+    },
+    "is_active": true,
+    "sort_order": 30,
+    "meta": {
+      "specialty": "cardiology"
+    }
+  },
+  "templates": [
+    {
+      "template_code": "heart_failure_core",
+      "is_required_on_activation": true,
+      "phase": "any",
+      "sort_order": 1
+    }
+  ]
+}

database/data/pathways/hypertension.json

@@ -0,0 +1,38 @@
+{
+  "pathway": {
+    "code": "hypertension",
+    "name": "Hypertension",
+    "description": "Hypertension clinical pathway.",
+    "match_rules": {
+      "icd_prefixes": [
+        "I10",
+        "I11",
+        "I12",
+        "I13",
+        "I15"
+      ],
+      "keywords": [
+        "hypertension",
+        "high blood pressure",
+        "htn",
+        "hypertensive"
+      ],
+      "exclude_keywords": [
+        "family history"
+      ]
+    },
+    "is_active": true,
+    "sort_order": 50,
+    "meta": {
+      "specialty": "cardiology"
+    }
+  },
+  "templates": [
+    {
+      "template_code": "hypertension_core",
+      "is_required_on_activation": true,
+      "phase": "any",
+      "sort_order": 1
+    }
+  ]
+}

database/data/pathways/orthopaedics.json

@@ -0,0 +1,38 @@
+{
+  "pathway": {
+    "code": "orthopaedics",
+    "name": "Orthopaedics",
+    "description": "Orthopaedics clinical pathway.",
+    "match_rules": {
+      "icd_prefixes": [
+        "S",
+        "M80",
+        "M81",
+        "M84"
+      ],
+      "keywords": [
+        "fracture",
+        "orthopaedic",
+        "orthopedic",
+        "dislocation",
+        "sprain"
+      ],
+      "exclude_keywords": [
+        "family history"
+      ]
+    },
+    "is_active": true,
+    "sort_order": 120,
+    "meta": {
+      "specialty": "orthopaedics"
+    }
+  },
+  "templates": [
+    {
+      "template_code": "orthopaedics_core",
+      "is_required_on_activation": true,
+      "phase": "any",
+      "sort_order": 1
+    }
+  ]
+}

database/data/pathways/parkinsons.json

@@ -0,0 +1,33 @@
+{
+  "pathway": {
+    "code": "parkinsons",
+    "name": "Parkinson's",
+    "description": "Parkinson's clinical pathway.",
+    "match_rules": {
+      "icd_prefixes": [
+        "G20"
+      ],
+      "keywords": [
+        "parkinson",
+        "parkinsons",
+        "parkinson's disease"
+      ],
+      "exclude_keywords": [
+        "family history"
+      ]
+    },
+    "is_active": true,
+    "sort_order": 90,
+    "meta": {
+      "specialty": "neurology"
+    }
+  },
+  "templates": [
+    {
+      "template_code": "parkinsons_core",
+      "is_required_on_activation": true,
+      "phase": "any",
+      "sort_order": 1
+    }
+  ]
+}

database/data/pathways/pregnancy.json

@@ -0,0 +1,36 @@
+{
+  "pathway": {
+    "code": "pregnancy",
+    "name": "Pregnancy",
+    "description": "Pregnancy clinical pathway.",
+    "match_rules": {
+      "icd_prefixes": [
+        "O",
+        "Z33",
+        "Z34"
+      ],
+      "keywords": [
+        "pregnancy",
+        "pregnant",
+        "antenatal",
+        "prenatal"
+      ],
+      "exclude_keywords": [
+        "family history"
+      ]
+    },
+    "is_active": true,
+    "sort_order": 110,
+    "meta": {
+      "specialty": "obstetrics"
+    }
+  },
+  "templates": [
+    {
+      "template_code": "pregnancy_core",
+      "is_required_on_activation": true,
+      "phase": "any",
+      "sort_order": 1
+    }
+  ]
+}

database/data/pathways/stroke.json

@@ -0,0 +1,68 @@
+{
+  "pathway": {
+    "code": "stroke",
+    "name": "Stroke",
+    "description": "Acute and follow-up stroke clinical pathway (includes TIA as subtype on assessments).",
+    "match_rules": {
+      "icd_prefixes": ["I60", "I61", "I62", "I63", "I64", "G45"],
+      "keywords": [
+        "stroke",
+        "cva",
+        "tia",
+        "transient ischaemic attack",
+        "transient ischemic attack",
+        "cerebrovascular",
+        "hemiplegia",
+        "ischaemic stroke",
+        "ischemic stroke",
+        "hemorrhagic stroke",
+        "haemorrhagic stroke"
+      ],
+      "exclude_keywords": ["family history"]
+    },
+    "is_active": true,
+    "sort_order": 10,
+    "meta": {
+      "specialty": "neurology",
+      "color": "rose"
+    }
+  },
+  "templates": [
+    {
+      "template_code": "nihss",
+      "is_required_on_activation": true,
+      "phase": "acute",
+      "sort_order": 1
+    },
+    {
+      "template_code": "mrs",
+      "is_required_on_activation": true,
+      "phase": "acute",
+      "sort_order": 2
+    },
+    {
+      "template_code": "gcs",
+      "is_required_on_activation": false,
+      "phase": "acute",
+      "sort_order": 3
+    },
+    {
+      "template_code": "stroke_clinical",
+      "is_required_on_activation": false,
+      "phase": "acute",
+      "sort_order": 4
+    },
+    {
+      "template_code": "stroke_swallow",
+      "is_required_on_activation": false,
+      "phase": "acute",
+      "sort_order": 5
+    },
+    {
+      "template_code": "barthel",
+      "is_required_on_activation": false,
+      "phase": "follow_up",
+      "sort_order": 6
+    }
+  ]
+}