AI Scribe for Rheumatologists
Document RA follow-ups, lupus management, joint injections, and biologic initiation with the joint count, DAS28-CRP, CDAI, and serologic trends already written. Built for the visits where structured exam data is the note.
Documentation for Every Rheumatology Visit
From the first inflammatory-vs-non-inflammatory triage to the long-haul lupus and RA follow-ups, the templates already understand what a rheumatology note has to say.
New Patient Workup
Inflammatory vs non-inflammatory triage, full joint exam, ANA/RF/anti-CCP/HLA-B27 ordering, and a working differential.
RA Follow-Up
Tender and swollen joint counts, DAS28-CRP or CDAI, methotrexate dose review, and treat-to-target adjustment.
Lupus Management
SLEDAI-2K elements, dsDNA and complement trends, hydroxychloroquine eye-exam compliance, and prednisone taper.
Joint Injection
Sterile field, needle size, intra-articular versus bursal, drug and dose (triamcinolone 40 mg most common), CPT 20610.
Biologic Initiation
TB IGRA, hepatitis B/C, vaccine status, prior DMARD failures documented for prior auth, infusion or self-inject plan.
Vasculitis Eval
GCA, GPA/MPA/EGPA: ANCA pattern, biopsy result, organ involvement (kidney, nerve, lung), and induction regimen.
Built for Treat-to-Target Rheumatology
The features that make a rheumatology note complete on the first draft — joint counts, scores, DMARD plans, and biologic safety screens.
DAS28 / CDAI narrative writes itself
When you call out tender and swollen joints during the exam, the note totals them, calculates DAS28-CRP if a recent CRP is on file, and writes a paragraph explaining whether the patient is in remission, low, moderate, or high activity.
Serology trending
Pulls the most recent RF, anti-CCP, ANA, anti-dsDNA, complement (C3/C4), ESR, and CRP into the assessment automatically. The trend, not just the latest value, is what matters in lupus and vasculitis.
DMARD and biologic plans
Captures methotrexate (oral vs subcutaneous, dose, folic acid), hydroxychloroquine 200 mg BID with annual eye exam reminder, prednisone taper schedule, and biologics (adalimumab 40 mg q2wk, etanercept 50 mg weekly, rituximab cycles).
ACR / EULAR 2019 lupus classification
For new SLE workups, the assessment can score the ACR/EULAR 2019 weighted criteria (entry ANA at 1:80 or higher, then domains: constitutional, hematologic, neuropsychiatric, mucocutaneous, serosal, musculoskeletal, renal, antiphospholipid, complement, SLE-specific antibodies).
Joint-injection note in 30 seconds
Procedure note pre-fills with informed consent, sterile prep, target structure, needle size, drug and dose, post-procedure exam, and CPT 20610/20605/20600 plus 76942 if ultrasound guided.
PMR / GCA workup
Captures shoulder and hip girdle pain, morning stiffness greater than 45 minutes, ESR/CRP elevation, temporal artery symptoms, vision changes, and prednisone 15-20 mg start (PMR) or 40-60 mg with same-day temporal artery biopsy referral (GCA).
A Real Day in Rheumatology Clinic
Why rheumatology notes punish dictation and reward ambient capture.
Rheumatology runs on structured exam data. A typical morning is two new patients, eight RA follow-ups, two lupus visits, a PMR, and a couple of joint injections. The note for an RA follow-up is mostly a joint count, a disease activity score (DAS28-CRP or CDAI), and a treat-to-target paragraph explaining whether the patient is in remission, low, moderate, or high activity. Rheumatologists who dictate their notes after the fact will tell you the joint count is the worst part — it is structured, easy to forget the exact joints, and tedious to read aloud.
Ambient capture is a better fit because the joint count is called out during the exam in real time. When you say "tender at the right second MCP, mild swelling at the left wrist, no synovitis at the MTPs," the note is already writing tender joint count, swollen joint count, and the locations. Combined with the most recent ESR and CRP, the assessment paragraph writes itself: low disease activity by DAS28-CRP, sustained response on combination MTX plus adalimumab, treat-to-target plan continued.
PatientNotes was tuned with feedback from rheumatologists in solo, group, and academic settings. The templates carry the language ACR and EULAR guidelines actually use: Boolean remission criteria, ACR/EULAR 2019 lupus classification, GCA temporal artery biopsy timing, hydroxychloroquine eye-exam reminder, and the prior-auth fields needed for biologic initiation. If you want to see this on your own visits, the 7-day trial is enough — most rheumatology users have a usable joint-count narrative on their first recorded visit.
Sample AI-Generated Rheumatology Note
An RA treat-to-target follow-up drafted from a 24-minute encounter. Edit, sign, paste into your EHR.
RHEUMATOLOGY FOLLOW-UP — RA TREAT-TO-TARGET Patient: 58F, seropositive RA dx 2019. On methotrexate + adalimumab. Date of service: 2026-04-22 Visit type: 99214 (Established, moderate MDM) SUBJECTIVE: 3-month follow-up. Reports overall improvement. Morning stiffness about 30 minutes (was 90 minutes 3 months ago). Pain (PROMIS): 4/10 average over the past week, worst 6/10 on a busy gardening day. Patient global assessment (VAS): 32/100. Functional status: HAQ-DI 0.625 — improved from 1.0 last visit. Adherence: methotrexate 15 mg subcutaneous weekly (last dose 2 days ago, no nausea), adalimumab 40 mg every 2 weeks (last 2026-04-15), folic acid 1 mg daily. No fevers, weight loss, oral ulcers, photosensitivity, Raynaud, dyspnea, or chest pain. LMP: post-menopausal. No new infections, no recent sick contacts. Skin test for TB Q-Gold negative at biologic start; due for re-screen 2026-09. OBJECTIVE: Vitals: BP 128/78, HR 72, T 36.7C, Wt 71.2 kg, BMI 26.4. Gen: Well-appearing, NAD. Skin: No rash, no rheumatoid nodules. JOINT EXAM (28-joint count): - Tender joints: 3 (R 2nd MCP, L 3rd MCP, L wrist) - Swollen joints: 2 (R 2nd MCP, L wrist) - No active synovitis at MTPs, knees, elbows, shoulders. - ROM near full at all 28; mild morning crepitus at L knee (osteoarthritic, stable). Cardiopulmonary: RRR, lungs clear. Patient examined supine and seated; no dactylitis, no enthesitis at insertion of Achilles bilaterally. LABS (drawn 2026-04-15): - CBC: WBC 6.4, Hgb 13.1, Plt 268. (Stable on MTX.) - CMP: Cr 0.82, AST 22, ALT 18 — no transaminitis. - ESR: 14 mm/hr (was 28 three months ago). - CRP: 0.6 mg/dL (was 1.4). - RF: 142 IU/mL (historically positive; not trended). - Anti-CCP: greater than 250 U/mL (high titer, baseline). - Hep B sAg negative, anti-HBc neg, anti-HBs greater than 100 mIU/mL (vaccinated). DISEASE ACTIVITY: - DAS28-CRP: 2.94 -> low disease activity (range 2.6-3.2 = low). Was 4.6 (moderate) at biologic start. - CDAI: 7 -> low disease activity (LDA, range 2.8-10). - Patient meets ACR/EULAR Boolean remission criteria? No (TJC 3 greater than 1, SJC 2 greater than 1) — close to LDA, not yet remission. ASSESSMENT: 1. Seropositive RA (M05.9) — sustained good response to combination MTX + adalimumab; in low disease activity by DAS28-CRP and CDAI; not yet at Boolean remission. Treat-to-target plan: continue current regimen, reassess in 3 months for remission target. 2. Methotrexate tolerance — no transaminitis, stable CBC. Continue 15 mg SC weekly with folic acid 1 mg daily. 3. Anti-TNF biologic on schedule — adalimumab 40 mg q2wk. TB Q-Gold re-screen due Sept 2026. 4. Cardiovascular risk — RA is an independent ASCVD risk factor. ASCVD 10-yr 8.9% — recommend statin discussion. 5. Bone health — on chronic glucocorticoid history (none currently). DXA scheduled for next year. 6. Vaccinations — flu given today. Pneumococcal series complete. Shingrix series due — ordered. PLAN: - Continue MTX 15 mg subcutaneous weekly + folic acid 1 mg daily. - Continue adalimumab 40 mg subcutaneous every 2 weeks. - Repeat CBC, CMP, ESR, CRP in 3 months. - TB Q-Gold and Hep B sAg re-screen due Sept 2026 — order placed. - DXA bone density Q1 2027. - Initiate moderate-intensity statin discussion at next visit (printed handout today). - Shingrix series ordered — 1st dose at pharmacy, 2nd dose 2-6 months later. - Patient counseled to call for any infection (sore throat, urinary symptoms, fever) given biologic. - Follow-up: 3 months. Sooner for flare. Time spent: 24 minutes face-to-face. Counseling and coordination: 9 minutes (statin, vaccine, biologic safety). Billing: 99214. ICD-10: M05.9, Z79.899 (long-term DMARD), Z79.890 (long-term biologic). Signed: PatientNotes Clinical Team (draft) — pending physician review.
Templates also ship for new SLE workup, PMR/GCA evaluation, joint injection (CPT 20610), and biologic initiation prior-auth packet.
Intelligent ICD-10 Suggestions
The codes rheumatologists reach for most often, surfaced as you document.
M05.9Rheumatoid arthritis with rheumatoid factor, unspecifiedM06.9Rheumatoid arthritis, unspecifiedM32.9Systemic lupus erythematosus, unspecifiedM35.3Polymyalgia rheumaticaM31.6Other giant cell arteritisM45.9Ankylosing spondylitis of unspecified sites in spineM10.9Gout, unspecifiedM79.7FibromyalgiaCPT companions: 99213/99214/99215 office E&M, 20610 (large joint injection), 20605 (medium), 20600 (small), 76942 (US guidance), 96401/96413 (infusion). Suggested per visit by time and MDM.
How Rheumatologists Actually Use It
Three composite cases drawn from real PatientNotes accounts. Names changed.
Dr. Lena Bauer
Solo private rheumatology, Madison WI
Lena built her practice around 25-minute slots and refused to add a 5pm charting block. She used a virtual scribe service for two years at $1,800/month. Switched to PatientNotes, dropped the scribe service, and her first month she signed her last note before 4:30pm. The DAS28 narrative was the surprise — she had been hand-typing the joint count summary for every RA follow-up.
Dr. Marcus Whitfield
Mid-size rheumatology group, 4 physicians, Atlanta GA
The group runs an in-office infusion suite alongside clinic. Marcus pushed to standardize their biologic initiation note so prior-auth letters carried the same fields every time. They built a shared template inside PatientNotes for TB, hepatitis, vaccines, and prior DMARD failures, and prior-auth turnaround dropped from a median of 11 days to 6. Group billing of $55/seat/month vs the $100+/month they were quoted by Suki.
Dr. Priya Anand
Hospital-employed rheumatologist, academic medical center, Boston
Priya is on the faculty at a teaching hospital that uses Epic and has a Nuance DAX pilot. She likes DAX in her resident clinic where she co-signs notes, but DAX struggles with her complex vasculitis cases where she needs the assessment to read like a real consult letter. She uses PatientNotes on her phone for those visits, paste-bridges into Epic, and edits the assessment paragraph rather than rebuilding it. She pays for PatientNotes herself; DAX comes with the institution.
Coming from Microsoft Dragon Medical One?
Honest comparison. Dragon is mature, EHR-integrated, and many rheumatologists know it well. The decision is dictation versus ambient.
Microsoft Dragon Medical One is the dictation tool many rheumatologists trained on during fellowship. It is mature, deeply integrated with Epic and Cerner SmartPhrases, and reasonable people still prefer it. The honest distinction is dictation versus ambient. With Dragon, after the visit you sit down, recall the joint count, and dictate it. With PatientNotes, you call out tender and swollen joints during the exam ("two-plus tender at the second MCP") and the joint count is captured live. For rheumatology — a specialty defined by structured exam findings — ambient capture is materially less work than redictating the same content from memory.
| Dimension | Dragon Medical One | PatientNotes |
|---|---|---|
| Pricing | $99-200/month per provider (Nuance/Microsoft subscription). | $50-70/month per provider on annual plan. No vendor minimums. |
| Setup | Microphone purchase, voice-profile training, IT-managed install. | Sign in on phone, web, or laptop. No hardware. |
| Style | Dictation. You speak the note out loud after the visit. | Ambient. Listens to the patient encounter and drafts the note. |
| EHR write-back | Deep Epic / Cerner integration via SmartPhrases. | Clipboard, Chrome extension, SMART-on-FHIR (rolling out 2026). |
| Rheumatology templates | You build your own SmartPhrases. | RA, lupus, PMR/GCA, joint injection, biologic initiation shipped. |
| Best for | Heavy SmartPhrase users with a settled Dragon workflow. | Rheumatologists who want the joint count and assessment written from the visit conversation. |
How to switch in 3 steps
- Sign up at patientnotes.ai and pick the Rheumatology specialty during onboarding so the joint-count and DAS28 templates load.
- On your next RA follow-up, record on your phone in your coat pocket. Keep Dragon open in parallel for a week if you want a safety net.
- After two weeks, compare your Dragon-dictated notes to the PatientNotes drafts. Most rheumatologists cancel Dragon at the end of the second week.
Detailed switch guide: Dragon Medical One vs PatientNotes.
PatientNotes vs Suki.ai
Suki is the AI scribe most often pitched to rheumatology groups. Here is the honest comparison.
Suki.ai is the AI scribe most often cited in rheumatology marketing materials and is a strong product. It started as a voice assistant ("Suki, add ICD-10 M05.9") and grew into an ambient scribe with deep Epic integration. The honest comparison: Suki is more capable on voice commands, more EHR-integrated where IT has done the work, and meaningfully more expensive. PatientNotes is faster to start, cheaper, and ships rheumatology-specific templates out of the box. The right choice depends on whether you have an Epic team building voice macros for you, or whether you want a personal scribe you set up over lunch.
| Dimension | Suki.ai | PatientNotes |
|---|---|---|
| Pricing | Suki: from $99/month. Premium plans, voice command add-ons, and EHR integration tiers push effective per-provider cost higher. | $50-70/month per provider on annual plan. All features included. |
| Time to first note | Days to weeks — IT scoping, voice profile, Epic integration. | Same day. Sign up, record one visit, edit, sign. |
| Voice command depth | Suki excels at "Suki, sign and submit" type voice control. | Lighter on voice control; stronger on ambient narrative. |
| Rheumatology tuning | Generic specialty model; rheum templates if you build them. | Pre-built templates for RA, lupus, PMR/GCA, joint injection, biologic init. |
| EHR integration | Direct Epic and Cerner write-back where IT has enabled it. | Clipboard, Chrome extension, SMART-on-FHIR write-back rolling out 2026. |
| Personal phone use | Generally requires managed device. | iOS, Android, web. BYOD friendly. |
| Best for | Multispecialty groups with an Epic team that will configure voice macros. | Solo and mid-size rheumatology groups that want a same-day, low-cost ambient scribe with rheum templates already built. |
Frequently Asked Questions
Specifics for rheumatologists evaluating an AI scribe. Updated April 2026.
Does PatientNotes work for rheumatology?
Yes. PatientNotes was tuned on RA follow-ups, new-onset SLE workups, PMR/GCA evaluations, vasculitis, joint injections, and biologic initiations. It captures joint exam (tender and swollen joint counts), disease activity scores like DAS28-CRP and CDAI, serology trends (RF, anti-CCP, ANA, dsDNA, complement), and the DMARD/biologic plan in one pass.
How much does an AI scribe cost for rheumatology?
PatientNotes is $50-70 per month for a single rheumatologist on the annual plan. Most specialty AI scribes (Suki at $99/month, Nuance DAX at $200+/month) are priced for hospital-employed clinicians. The cost gap matters in private rheumatology practices where margins are tight after biologic infusion buy-and-bill.
Is Suki better than PatientNotes for rheumatology?
Suki.ai is a strong product with deep voice command support and is widely deployed in multispecialty groups. The honest comparison: Suki is more expensive ($99/month base plus add-ons), more EHR-integrated where IT has done the work, and slower to set up. PatientNotes wins on price, same-day setup, and pre-built rheumatology templates (DAS28 narrative, biologic initiation checklist, joint injection note). Suki wins where you have an Epic deployment with custom voice macros already built.
Can rheumatology-specific notes be auto-generated?
Yes. Templates ship for RA initial workup, RA follow-up with joint count and DAS28 calculation, SLE new diagnosis (with ACR/EULAR 2019 classification weighting), PMR/GCA workup, biologic initiation (TB and hepatitis screening, vaccine status, infusion plan), and joint injection note (CPT 20610). Each template surfaces the disease-activity narrative, not just the labs.
Does it integrate with athenahealth and eClinicalWorks?
Yes. Most outpatient rheumatology in the US runs on athenahealth, eClinicalWorks, or Epic Community Connect. PatientNotes paste-bridges into all three via clipboard, the Chrome extension, or our SMART-on-FHIR write-back rolling out during 2026. The clipboard flow takes about three seconds per note and is what most rheumatologists prefer because it lets you edit before the chart is signed.
Will it help me bill rheumatology-specific CPT codes correctly?
Yes. Office E&M (99213/99214/99215) is suggested by time and MDM, with infusion codes (96401, 96413), joint injection codes (20610 large joint, 20605 medium, 20600 small), and ultrasound guidance (76942) flagged when relevant. The MDM scoring takes into account number of DMARDs, biologic management, comorbid CKD or hepatitis, and recent infusions, which is why RA follow-ups on biologics frequently support 99214.
How do I switch from Dragon Medical One to PatientNotes?
Dragon Medical One is dictation: you talk after the visit and it types. PatientNotes is ambient: it listens during the visit and writes the note. To switch, sign up at patientnotes.ai, record one RA follow-up on your phone in your coat pocket, paste the note into your EHR, and compare to your Dragon-dictated equivalent. Most rheumatologists cancel Dragon within two weeks once their joint count narrative writes itself.
Is it HIPAA compliant for rheumatology?
Yes. PatientNotes is HIPAA compliant, signs a BAA with every paying account, and encrypts audio and notes in transit and at rest. You can configure zero-retention audio (audio is purged after the note generates) which is a sensible default for rheumatology where genetic and reproductive history routinely surface in lupus, scleroderma, and vasculitis visits.
Joint count, DAS28, plan — written before you sit down to chart.
7-day free trial. No credit card. Rheumatology templates ready on first sign-in.
$50-70/month after trial. HIPAA compliant. BAA on every paying account.