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/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
+    }
+  ]
+}