Rheumatology APCM Implementation Checklist | Tile Healthcare

Identify patients with RA, SLE, or PsA who are on high-cost biologic therapies or immunosuppressants.

Ensure patients have two or more chronic conditions expected to last at least 12 months, such as RA and Osteoarthritis.

Obtain and document verbal or written consent for APCM services, explaining the 24/7 access benefits.

Utilize AI voice assistants to contact patients on the 3-6 month waitlist to explain the benefits of APCM monitoring.

Confirm coverage for APCM-specific codes with Medicare and private payers to ensure reimbursement.

Set up automated reminders for quarterly CBC, CMP, and LFTs required for methotrexate and biologic safety.

Ensure annual TB and Hepatitis screening is scheduled and completed for all patients on TNF inhibitors.

Integrate APCM workflows with specialty pharmacies to prevent gaps in biologic therapy and handle prior authorizations.

Create a dedicated digital pathway for patients to report injection site reactions or signs of infection immediately.

Verify that specific monitoring requirements for high-risk rheumatologic medications are documented in the care plan.

Implement AI voice systems to identify urgent flare symptoms like joint swelling or fever and escalate to clinical staff.

Use validated tools like RAPID3 or DAS28 during monthly APCM check-ins to monitor disease activity scores.

Ensure patients have a clear, automated path to reach the care team after hours to prevent unnecessary ER visits.

Perform monthly reviews of biologic or DMARD adherence to identify barriers like cost, side effects, or needle phobia.

Track cardiovascular risk and bone density (DEXA) screenings, which are critical for chronic steroid users.