feat(ai): Phase 2B 洞察→推送→反馈闭环 — 风险评分+通知+建议反馈

- 风险评分引擎 load_patient_data 实装（体征+化验异常）
- refresh_all_patients 高风险自动创建洞察+事件推送
- erp-message 订阅 copilot.insight.created 推送医护通知
- 每日 cron 增加洞察过期清理+建议过期清理
- POST /ai/suggestions/{id}/feedback 建议反馈端点
- SuggestionFeedbackService 反馈服务层
- 小程序健康页建议卡片增加采纳/忽略/咨询医生按钮

crates/erp-message/src/module.rs

@@ -1,6 +1,6 @@
 use axum::Router;
 use axum::routing::{delete, get, put};
-use sea_orm::{ColumnTrait, EntityTrait, QueryFilter};
+use sea_orm::{ColumnTrait, EntityTrait, FromQueryResult, QueryFilter};
 use std::sync::Arc;
 use tokio::sync::Semaphore;
 use uuid::Uuid;
@@ -1003,6 +1003,69 @@ async fn handle_workflow_event(
                 "医生在线状态变更"
             );
         }
+        // AI Copilot 洞察生成 → 通知主管医生
+        "copilot.insight.created" => {
+            let patient_id = event
+                .payload
+                .get("patient_id")
+                .and_then(|v| v.as_str())
+                .and_then(|s| uuid::Uuid::parse_str(s).ok());
+            let severity = event
+                .payload
+                .get("severity")
+                .and_then(|v| v.as_str())
+                .unwrap_or("warning");
+            let title = event
+                .payload
+                .get("title")
+                .and_then(|v| v.as_str())
+                .unwrap_or("AI 健康洞察");
+
+            if let Some(pid) = patient_id {
+                // 查询患者的责任医生（通过 follow_up_task 的 assigned_to）
+                #[derive(sea_orm::FromQueryResult)]
+                struct DoctorRow {
+                    assigned_to: uuid::Uuid,
+                }
+                let doctor: Option<DoctorRow> = DoctorRow::find_by_statement(
+                    sea_orm::Statement::from_sql_and_values(
+                        sea_orm::DatabaseBackend::Postgres,
+                        "SELECT assigned_to FROM follow_up_task WHERE tenant_id = $1 AND patient_id = $2 AND assigned_to IS NOT NULL AND deleted_at IS NULL AND status IN ('pending', 'in_progress') ORDER BY created_at DESC LIMIT 1",
+                        [event.tenant_id.into(), pid.into()],
+                    ),
+                )
+                .one(db)
+                .await
+                .unwrap_or(None);
+
+                if let Some(doc) = doctor {
+                    let priority = match severity {
+                        "critical" => "urgent",
+                        "warning" | "high" => "important",
+                        _ => "normal",
+                    };
+                    if should_skip_for_dnd(event.tenant_id, doc.assigned_to, priority, db).await {
+                        return Ok(());
+                    }
+                    let _ = crate::service::message_service::MessageService::send_system(
+                        event.tenant_id,
+                        doc.assigned_to,
+                        format!("AI 健康洞察：{}", title),
+                        format!(
+                            "AI 系统检测到患者存在「{}」级别的健康风险，请及时关注。洞察内容：{}",
+                            severity, title
+                        ),
+                        priority,
+                        Some("ai_insight".to_string()),
+                        Some(event.id),
+                        db,
+                        event_bus,
+                    )
+                    .await
+                    .map_err(|e| e.to_string())?;
+                }
+            }
+        }
         // 关怀计划激活 — 温暖通知患者
         "care_plan.activated" => {
             let patient_id = event