Rheumatoid arthritis management
See your flares coming.
Stay on your meds.
Keep your joints.
Joint pain logs, DMARD and biologic adherence, flare pattern tracking, and wearable data - so you and your care team know what's happening between appointments, before joint damage sets in.
HIPAA compliant · Works with Apple Watch & Oura · Smart pillbox via Tenovi · RTM billing eligible
How it works
From scattered symptoms
to a clear RA picture.
RA is managed day by day - not just at quarterly appointments. Ziva connects your medication schedule, joint symptom logs, flare tags, and wearable data into one continuous record so you and your rheumatologist always know what's happening.
1
Set up your medication schedule
Add your DMARDs (methotrexate, hydroxychloroquine) or biologics. Isabella builds reminders and tracks every dose. Optional: connect a Tenovi smart pillbox for automatic detection.
2
Log joint symptoms daily — you enter these
Each morning, Isabella prompts you to log: morning stiffness duration (how many minutes until you feel loose), swollen joint count and location, pain score (0–10), fatigue level, and any activity limitation. Takes under a minute. Everything is timestamped and correlated with your medication history automatically.
3
Connect your wearable (optional)
Apple Watch or Oura adds HRV, resting heart rate, sleep quality, and step count - streamed daily. HRV drops are often an early signal of inflammation before joint symptoms worsen.
4
Isabella identifies your flare patterns
Isabella correlates your symptom logs, medication timing, HRV, sleep, and activity - identifying your personal flare signals so you can catch them earlier than ever before.
5
Monthly report shared with your provider
DMARD adherence, symptom frequency, flare log, pain and stiffness trends, and Isabella's observations - ready before every appointment. Supports RTM billing.
Isabella · What's changing this week
Morning stiffness
↑ 45 min
Pain score
6.1 / 10
DMARD adherence
72% ↓
HRV ⌚
38ms ↓
Activity today
Low
Fatigue
Moderate
Isabella · Today's priority
"Morning stiffness is up to 45 minutes — that's 3× your baseline. Combined with your HRV drop and the 2 missed DMARD doses this week, this looks like the start of a flare. I've flagged this for your provider. Take your next dose on schedule tonight and rest today. Logging your joint locations when you feel swelling will help your rheumatologist see exactly where it's building."
Flare pattern recognition
Know a flare is coming
before it arrives.
Most RA patients learn to recognise their flares in hindsight. Ziva builds a personal flare signature from your symptom history - the specific pattern of morning stiffness duration, HRV drop, sleep disruption, and missed doses that precedes your flares. Isabella flags it when the pattern emerges again.
✓Morning stiffness duration logged daily — the most reliable early flare signal, often increasing 2–3 days before peak
✓HRV drop from wearable — systemic inflammation suppresses HRV before joints worsen, giving you an earlier warning
✓Swollen joint count tracked by location — wrists, fingers, knees, and ankles logged separately for your rheumatologist
✓Flare history log — every flare timestamped with preceding signals so your provider can see what triggers yours specifically
Flare pattern — Maria L.*, last 4 weeks
Morning stiffness
↑ 15 → 45 min
over 3 days
Joint swelling
Wrists + fingers
bilateral
DMARD adherence
72% this wk
↓ from 96% avg
HRV ⌚
38ms ↓
from 54ms
Previous flare — same pattern (6 weeks ago)
Morning stiffness increaseDay −3
HRV drop below 42msDay −2
Swelling onsetDay 0
Flare peakedDay +2
Isabella · Flare warning
"Your current pattern matches your flare from 6 weeks ago — morning stiffness increasing over 3 days, HRV now below your flare threshold of 42ms, bilateral wrist swelling starting. That flare peaked 2 days after onset. Getting your DMARD dose on schedule today and messaging your provider now could significantly reduce severity."
Symptom trend — last 30 days
Pain score average4.2 / 10 ↑
Fatigue days9 of 30
Activity limited days6 of 30
DMARD adherence89% avg
Medication tracking — Maria L.*, this month
Methotrexate (weekly)
89% adherence
8 doses tracked · 1 late · 1 missed · Smart pillbox via Tenovi
Hydroxychloroquine (daily)
94% adherence
26 of 28 doses taken on schedule · 2 late
Isabella · Medication insight
"Your methotrexate adherence dropped this week to 72% — 2 doses late and 1 missed. Looking at your flare history, the 3 most recent flares each occurred in weeks where methotrexate adherence fell below 80%. Getting back on schedule this week is the most important thing you can do right now. Your pillbox alert should have fired Thursday — did the reminder not come through?"
Medication adherence
DMARDs only work
when you take them.
DMARDs and biologics are the foundation of RA management - but they require consistent, long-term adherence that's hard to maintain. The Tenovi smart pillbox detects every dose automatically. Isabella correlates missed doses with your flare history, shows you the pattern, and reminds you before the next dose window closes.
✓Tenovi smart pillbox — detects opening, closing, and refill events automatically. No logging needed.
✓Smart reminders — Isabella alerts you before missed dose windows, not just at scheduled times
✓Flare correlation — Isabella shows whether your flares follow missed dose patterns, specific to your history
✓Adherence report — 30-day log shared with your provider before every appointment
✓Multiple medications supported — DMARDs, biologics, and corticosteroids all tracked in one place
For your care team
Your rheumatologist sees
the same data.
Before every visit.
When your provider is on Ziva, they see your DMARD adherence, flare history, morning stiffness trends, and pain scores - before every appointment. No more summarising months of symptoms from memory.
Refer Ziva to my provider / care team
Your rheumatologist isn't on Ziva yet? Send them a link - they'll see your DMARD adherence, flare patterns, joint symptom trends, and HRV data before every appointment, and can adjust your care plan directly from the portal.
Send to my provider →Already seeing your provider?
Bring your 30-day report to your next appointment - DMARD adherence, flare log, symptom trends, and Isabella's observations - ready to print or share from the app.
Get my report →What your provider sees
✓DMARD and biologic adherence log — every dose timestamped, missed doses flagged, 30-day percentage
✓Flare history — each flare logged with preceding signals, joint locations, severity, and duration
✓Morning stiffness duration — daily log, 30-day trend, correlated with medication timing
✓Pain and fatigue scores — daily patient-reported outcomes, averaged over 30 days
✓HRV and sleep from wearable — inflammation's impact on recovery visible over months
✓Isabella's clinical summary — key observations and suggested discussion points before every visit
RTM billing eligible
Rheumatoid arthritis qualifies for Remote Therapeutic Monitoring (RTM) billing under musculoskeletal codes. Ziva's daily symptom logs and medication check-ins generate the data transmissions needed for billing codes 98977 (16+ days) or 98985 (2–15 days, new 2026). Share the provider page for full details.
Questions
Common questions
No - Ziva works without either. DMARD adherence tracking (via app logging), joint symptom tags, flare pattern recognition, and Isabella's coaching are all available from the app alone. The Tenovi smart pillbox (optional) removes the need to log manually - it detects every dose automatically. Connecting an Apple Watch or Oura adds HRV and sleep context that enriches flare prediction.
The Tenovi smart pillbox detects and records every time the pillbox is opened, closed, or refilled - automatically timestamped and synced to Ziva via the Tenovi integration. Isabella correlates each dose event with your symptom logs and flare history. No patient logging required. Works for weekly medications like methotrexate and daily medications like hydroxychloroquine.
Isabella builds a personal flare profile from your symptom history - the specific combination of early warning signals that precede your flares. For most RA patients, this includes morning stiffness duration increasing, HRV dropping below a personal threshold, sleep quality declining, and a recent missed or late DMARD dose. When the same pattern emerges again, Isabella flags it before the flare peaks so you can contact your provider early.
Morning stiffness duration (in minutes), swollen joint count and location (wrists, fingers, knees, ankles, elbows), pain score (0–10), fatigue level, and activity limitation. Each tag is timestamped and correlated with your medication history and wearable data. You can also add free-text notes for context your provider might need.
Yes - many RA patients have cardiovascular comorbidities or are on corticosteroids that affect blood pressure and weight. Ziva supports Tenovi's Bluetooth blood pressure monitor and weight scale alongside the smart pillbox. All readings are timestamped and included in your monthly report. If you're on a biologic with cardiovascular considerations, your provider can set alert thresholds directly in the portal.
No. Ziva is a monitoring and adherence tool, not a clinical substitute. It helps you track symptoms, stay on your medication schedule, identify patterns, and share better information with your rheumatologist - so your appointments are more productive. It does not provide clinical advice, change your prescription, or replace your care team. Always follow your provider's guidance. In an emergency, call 911.