feat(integrations): demo adapters for МИС, connect-code identity, ГРЛС excerpts, doctor notifier

- setup() at package import (idempotent, replaces only base.py defaults): MisMock, ConnectCodeIdentity,
  GrlsExcerpts, CompositeNotifier; outbox stays MemoryOutbox
- MisMock: clinical DB prescriptions, fallback data/meds/mis_prescriptions.json (synthetic, by token)
- ConnectCodeIdentity: one-time connect code via identity_repo, 15 min grace for the double check in one
  connect flow (Telegram /start + engine `new` state)
- GrlsExcerpts: synthetic paraphrased instruction excerpts for sertraline, paroxetine, escitalopram,
  fluoxetine, mirtazapine, prazosin
- CompositeNotifier: in-memory feed (recent(since_id)) + Telegram doctor chat, PII-free, never raises
- test_llm_med_qa: default-registry test now patches NoDrugInfo explicitly

Refs #14

Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>

app/integrations/mis_mock.py

@@ -0,0 +1,97 @@
+"""МИС / ЕГИСЗ stand-in: the patient's prescriptions (SPEC §9).
+
+Source order: the clinical DB table `prescriptions` (written when the doctor connects a patient or by the
+demo seed), then the synthetic catalogue `data/meds/mis_prescriptions.json` keyed by token. In prod this is
+a regional МИС query; the Protocol stays the same.
+"""
+
+import json
+import logging
+from datetime import date
+from pathlib import Path
+from typing import Any
+
+from pydantic import BaseModel, Field, ValidationError
+from sqlalchemy import select
+from sqlalchemy.exc import SQLAlchemyError
+
+from app.config import get_settings
+from app.integrations.base import Prescription
+
+log = logging.getLogger(__name__)
+
+
+class _CatalogPatient(BaseModel):
+    persona: str
+    tokens: list[str] = Field(default_factory=list)
+    prescriptions: list[Prescription]
+
+
+class _Catalog(BaseModel):
+    patients: list[_CatalogPatient]
+
+
+def _from_row(drug: str, dose: str, schedule: dict[str, Any], start: date | None, end: date | None) -> Prescription:
+    # The table has no instructions column; the doctor's note («утром после еды») may ride in the schedule JSON.
+    times = {k: [str(x) for x in v] for k, v in schedule.items() if isinstance(v, list)}
+    return Prescription(
+        drug=drug,
+        dose=dose,
+        schedule=times or {"times": ["08:00"]},
+        instructions=str(schedule.get("instructions") or ""),
+        start_date=start,
+        end_date=end,
+    )
+
+
+def default_catalog_path() -> Path:
+    return get_settings().data_dir / "meds" / "mis_prescriptions.json"
+
+
+class MisMock:
+    """`PrescriptionSource`: clinical DB first, synthetic JSON catalogue as the fallback."""
+
+    def __init__(self, catalog_path: Path | None = None, *, use_db: bool = True) -> None:
+        self._path = catalog_path
+        self._use_db = use_db
+        self._by_token: dict[str, list[Prescription]] | None = None
+
+    def _catalog(self) -> dict[str, list[Prescription]]:
+        # Lazy: the package is imported before startup, a missing/broken file must not break the import.
+        if self._by_token is None:
+            path = self._path or default_catalog_path()
+            index: dict[str, list[Prescription]] = {}
+            try:
+                catalog = _Catalog.model_validate(json.loads(path.read_text(encoding="utf-8")))
+            except (OSError, ValueError, ValidationError) as exc:
+                log.warning("mis_mock catalogue not loaded error=%s", type(exc).__name__)
+                catalog = _Catalog(patients=[])
+            for patient in catalog.patients:
+                for token in patient.tokens:
+                    index[token] = patient.prescriptions
+            self._by_token = index
+        return self._by_token
+
+    async def _from_db(self, token: str) -> list[Prescription]:
+        from app.db.clinical import Prescription as PrescriptionRow
+        from app.db.session import get_clinical_session
+
+        async with get_clinical_session() as s:
+            rows = (
+                await s.scalars(
+                    select(PrescriptionRow).where(PrescriptionRow.token == token).order_by(PrescriptionRow.id)
+                )
+            ).all()
+        return [_from_row(r.drug, r.dose, r.schedule or {}, r.start_date, r.end_date) for r in rows]
+
+    async def get_prescriptions(self, token: str) -> list[Prescription]:
+        if self._use_db:
+            try:
+                found = await self._from_db(token)
+            except (OSError, SQLAlchemyError) as exc:
+                # DB down or not migrated: the demo still shows the catalogue prescription.
+                log.warning("mis_mock db lookup failed error=%s", type(exc).__name__)
+                found = []
+            if found:
+                return found
+        return [p.model_copy(deep=True) for p in self._catalog().get(token, [])]