feat: HL7/FHIR, e-prescribing & insurance claims integrations

Real, standards-compliant integration clients that the clinic points at
its own (sandbox or production) endpoints — no mock data.

backend:
- `integrations` table (per org+type) storing endpoint + encrypted
  credentials (reusing the AI-key crypto) + status; Drizzle migration
- services/integrations:
  - fhir.ts — FHIR R4 REST client (pull lab Observations → patient
    record), HL7 v2 ORU parsing, capability-statement connection test
  - eprescribe.ts — NCPDP SCRIPT NewRx message build + transmit
  - claims.ts — X12 837P claim generation + 835 remittance parsing
- `/api/integrations` route: config GET/PUT (owner/admin), connection
  test, and the FHIR sync / HL7 ingest / e-Rx send / claim submit actions,
  RBAC-gated (lab/patient, prescription, invoice)

frontend:
- lib/integrations.ts client
- Settings → Integrations tab to configure endpoints/credentials/enable
  + test each integration
- on-page actions, shown only when the integration is enabled:
  Lab page → FHIR "Sync results" card; prescription sheet → "Send to
  pharmacy"; invoice sheet → "Submit claim"

Production e-Rx/claims routing requires the clinic's own Surescripts /
clearinghouse credentials; the code transmits real messages once supplied.

Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>

frontend/components/prescriptions/prescription-detail-sheet.tsx

@@ -3,6 +3,7 @@
 import { Trash2 } from "lucide-react";
 import { useTranslation } from "react-i18next";
 
+import { SendToPharmacyButton } from "@/components/integrations/integration-actions";
 import { Avatar, AvatarFallback } from "@/components/ui/avatar";
 import { Badge } from "@/components/ui/badge";
 import { Button } from "@/components/ui/button";
@@ -142,12 +143,20 @@ export function PrescriptionDetailSheet({
             </div>
           )}
         </SheetPanel>
-        {rx && onDelete && (
+        {rx && (
           <SheetFooter>
-            <Button onClick={onDelete} type="button" variant="destructive">
-              <Trash2 className="size-4" />
-              {t("prescriptions.detail.delete")}
-            </Button>
+            {onDelete && (
+              <Button
+                className="sm:mr-auto"
+                onClick={onDelete}
+                type="button"
+                variant="destructive"
+              >
+                <Trash2 className="size-4" />
+                {t("prescriptions.detail.delete")}
+              </Button>
+            )}
+            <SendToPharmacyButton rxId={rx.id} />
           </SheetFooter>
         )}
       </SheetPopup>