Multiple sclerosis management
See your relapses coming.
Stay on your DMT.
Stay in control.
Daily fatigue tracking, relapse signal detection, DMT adherence, and walking data - so you and your neurologist know what's happening between appointments, and can act before a relapse peaks.
HIPAA compliant · Works with Apple Watch & Garmin · Smart pillbox via Tenovi · RTM billing eligible
How it works
From scattered symptoms
to a clear MS picture.
MS is managed day by day - not just at quarterly neurology visits. Ziva connects your DMT schedule, fatigue logs, symptom tags, relapse history, and walking data into one continuous record so you and your neurologist always know what's happening.
1
Set up your DMT schedule
Add your disease-modifying therapy - injectable (interferon beta, glatiramer), oral (dimethyl fumarate, fingolimod), or infusion cycle. Isabella builds reminders and tracks every dose.
2
Check in daily — you enter these
Each day, Isabella prompts you to log: fatigue severity (0–10), any new neurological symptoms, pain, sleep quality, heat sensitivity, bladder or cognitive difficulty. Takes under a minute, even on tough days. Voice logging available.
3
Connect your wearable (optional)
Apple Watch or Garmin adds daily walking speed, step count, gait cadence, and sleep quality - streamed automatically. Walking slowdown is one of the most sensitive early signals of a motor relapse beginning.
4
Isabella identifies your relapse patterns
Isabella correlates your fatigue trends, walking data, DMT timing, sleep, and new symptom flags - building your personal relapse signature so you can recognise it earlier, and act sooner.
5
Monthly report shared with your provider
DMT adherence, relapse log, fatigue trends, walking data, and Isabella's observations - ready before every neurology appointment. Supports RTM billing.
Isabella · What's changing this week
Fatigue
8 / 10 ↑
Walking speed ⌚
↓ 18%
DMT adherence
74% ↓
Sleep quality ⌚
Poor
New symptoms
Visual
Isabella · Today's priority
"Your fatigue has been severe for 5 days and you've had a new visual symptom — blurred vision in your left eye — for 3 days. Your walking has slowed and you missed 2 DMT injections this month. This pattern matches your previous 2 relapses. Contact your neurologist today — early treatment in the first 24–48 hours makes a real difference to recovery. Take today's injection now if you missed it."
Relapse detection
Know a relapse is building
before it peaks.
Most MS relapses follow a pattern - fatigue building, a new symptom appearing, walking slowing down. Ziva builds your personal relapse signature from your history and flags when the same pattern emerges again. The earlier you contact your neurologist, the better the treatment outcome.
✓Fatigue severity tracked daily — the earliest and most consistent pre-relapse signal, often rising 3–5 days before neurological symptoms
✓New symptom logging by domain — visual, motor, sensory, bladder, cognitive — each tagged with date and severity
✓Walking speed decline from wearable — a sustained drop in your daily pace is a sensitive early motor signal Isabella watches for
✓Relapse log — every past relapse timestamped with preceding signals, symptom domains, and recovery timeline
Relapse pattern — Sophie A.*, last 4 weeks
Fatigue trend
↑ 3 → 8/10
over 5 days
New symptom
Visual · L eye
3 days ago
Walking speed ⌚
↓ 18%
vs. baseline
DMT adherence
74% this mo.
↓ from 98% avg
Previous relapse — same pattern (8 months ago)
Fatigue began increasingDay −5
Walking decline notedDay −3
Visual symptom appearedDay 0
IV methylprednisoloneDay +1
Isabella · Relapse signal
"Your pattern matches the relapse from 8 months ago — fatigue building over 5 days, then a visual symptom, then walking slowing down. That time, you got steroids on day 1 and recovered well. You're in the same window now. Contact your neurologist today — don't wait for it to get worse. I've already flagged this for your care team."
30-day summary
Fatigue avg (30 days)4.8 / 10
High fatigue days (≥7)8 of 30
Walking vs. 30-day avg ⌚↓ 18%
DMT adherence (monthly avg)91% avg
DMT tracking — Sophie A.*, this month
Interferon beta-1a (3× weekly)
74% this month
8 doses this month · 2 missed · correlates with rising relapse risk
Baclofen (spasticity · daily)
96% this month
27 of 28 doses on time · 1 late
Isabella · Medication insight
"Your interferon adherence dropped to 74% this month — 2 missed injections. Looking at your relapse history, every relapse in the past 2 years followed a month where adherence fell below 85%. The injection you missed on Tuesday is the one that would have been most protective given your fatigue trajectory. Take your next scheduled injection tonight — I'll send a reminder 2 hours before."
DMT adherence
Your DMT only works
when you take it consistently.
DMT adherence is the single strongest predictor of long-term MS outcome - but injections are easy to miss and oral medications are easy to forget. Ziva tracks every dose across all formulations, shows you how missed doses connect to your relapse history, and reminds you before a gap opens.
✓All DMT formulations supported — injectable, oral, and infusion cycle tracking in one place
✓Optional Tenovi smart pillbox — detects oral DMT doses automatically, no logging needed
✓Relapse correlation — Isabella shows whether your relapses follow missed dose patterns, specific to your history
✓Smart reminders — alerts before missed injection windows, not just at schedule time
✓Monthly adherence report — shared with your neurologist before every appointment
For your care team
Your neurologist sees
the same data.
Before every visit.
When your provider is on Ziva, they see your DMT adherence, relapse history, fatigue trends, and walking data - before every appointment. No more summarising months of symptoms from memory in a 20-minute slot.
Refer Ziva to my provider / care team
Your neurologist isn't on Ziva yet? Send them a link - they'll see your DMT adherence, relapse patterns, fatigue trends, and walking data in the provider portal, and can act on alerts before your next appointment.
Send to my provider →Already seeing your provider?
Bring your 30-day report to your next appointment - DMT adherence, relapse log, fatigue trends, walking data, and Isabella's observations - ready to print or share from the app.
Get my report →What your provider sees
✓DMT adherence log — every dose timestamped across all formulations, missed doses flagged
✓Relapse history — each relapse logged with preceding signals, symptom domains, severity, and recovery
✓Fatigue trend — daily severity over 30 days, high-fatigue days highlighted
✓Walking speed and gait from wearable — daily trend against personal baseline
✓New symptom log by domain — visual, motor, sensory, bladder, cognitive, timestamped
✓Isabella's clinical summary — relapse signal status and key observations before every visit
RTM billing eligible
Multiple sclerosis qualifies for Remote Therapeutic Monitoring (RTM) under musculoskeletal codes. Daily symptom logs and medication check-ins generate the data transmissions for CPT 98977 (16+ days) or 98985 (2–15 days, new 2026). Share the provider page for full billing details.
Questions
Common questions
Yes. For relapsing-remitting MS, Isabella focuses on relapse pattern detection and DMT adherence. For secondary or primary progressive MS, where discrete relapses are less common, Isabella monitors longer-term trends: fatigue trajectory, gradual walking decline, quality of life scores, and symptom domain progression. Monitoring parameters are customisable to your MS subtype and current treatment.
Injectable DMTs are tracked via daily app logging. Isabella sends a reminder before each injection window and prompts you to confirm after. You can also add a brief side-effect note (e.g. injection site reactions, flu-like symptoms) which is logged alongside adherence. An optional wearable temperature sensor integration can help flag post-injection systemic reactions if you experience them frequently.
Over your first few months of use, Isabella analyses the signals that consistently precede your relapses - which symptom domains appear first, how your fatigue changes, how your walking speed shifts, and whether missed DMT doses are a consistent factor. When that same combination of signals appears again, Isabella flags it - typically 2–5 days before a full relapse would present. The more history Ziva has, the sharper the pattern recognition becomes.
No. Ziva works without a wearable. DMT adherence tracking, daily symptom logs, relapse pattern recognition, and Isabella's coaching are all available from the app alone. A wearable (Apple Watch, Garmin, or Fitbit) adds walking speed and gait data - an additional early relapse signal, especially for motor-dominant MS. It's recommended if mobility is a concern for you, but not required to start.
Contact your MS nurse or neurologist the same day. Early treatment - typically IV methylprednisolone - is most effective in the first 24–48 hours of a relapse. Do not wait for symptoms to worsen before reaching out. Isabella's alert goes to your provider too (if they're on Ziva), but you should also call directly - don't assume the message is enough on its own. If symptoms include sudden vision loss, severe limb weakness, or difficulty swallowing, go to the emergency department.
No. Ziva is a monitoring and adherence tool, not a clinical substitute. It helps you track symptoms, stay on your DMT, understand your patterns, and share better information with your care team. It does not provide clinical advice, prescribe treatment, or replace your MS care team. Always follow your provider's guidance. In a medical emergency, call 911.