Cardiac implantable electronic device management has changed dramatically.
Remote monitoring programs are managing more patients, more transmissions, more device data, and greater operational complexity, often without a corresponding increase in staff. That growing data burden in cardiac remote monitoring is putting increasing pressure on device clinic workflows.
That challenge is at the center of EP Lab Digest's 2026 Cardiac Implantable Electronic Device Management supplement, which examines the strategies, technologies, and operating models being used to build scalable CIED programs.
Octagos is featured in the supplement.
So, what should a modern CIED remote monitoring program actually be able to do?
What should you look for in a CIED remote monitoring platform?
A modern CIED remote monitoring platform should help cardiac practices manage transmissions across device manufacturers, reduce non-actionable workload, support timely clinical review, produce consistent documentation, integrate with the EHR, maintain historical patient data, support billing workflows, and keep disconnected patients engaged.
Here are 10 questions worth asking when evaluating a remote monitoring partner.
1. Can it manage every major CIED manufacturer in one workflow?
Device clinics should not need separate processes for every manufacturer.
Octagos supports all major CIED manufacturers within one workflow. In-clinic transmissions from supported programmers can also flow through OctaSync™, including discrete device data and PDFs.
For practices evaluating remote monitoring software, this is an important question:
How much of the device workflow can actually be consolidated?
2. How does AI fit into clinical decision-making?
AI in remote cardiac monitoring is increasingly being used to help manage transmission volume, but automation alone does not eliminate the need for clinical judgment.
Octagos uses what we call the Two-Brain Approach™.
Atlas AI™ evaluates incoming transmissions, incorporates clinical context, and prioritizes them by acuity. An IBHRE certified technician then reviews the transmission and makes the determination before it reaches the clinic.
In peer-reviewed research published in JACC: Advances, Atlas AI™ was evaluated across 690,673 transmissions from 74,217 devices at 78 U.S. clinics. The Two-Brain Approach™ achieved 99.5% final-report accuracy.
The goal is to help the right information reach the care team at the right time.
For a deeper look at the workflow, see how AI triage is changing cardiac device monitoring.
3. Can the platform reduce non-actionable transmission burden?
One of the biggest challenges in CIED remote monitoring is the amount of information competing for clinicians' attention.
Octagos has demonstrated a 57% reduction in non-actionable transmissions reaching clinic staff, helping teams focus more of their time on clinically relevant findings. Octagos' research and publications page provides additional data on this analysis.
As alert volume grows, the issue can extend beyond efficiency to workflow stability and patient safety. Read more about when remote monitoring alerts become a clinical risk.
For organizations comparing remote monitoring vendors, ask:
What percentage of incoming transmissions ultimately require my team's attention, and what evidence supports that number?
4. How quickly are transmissions reviewed?
Turnaround time matters, particularly for urgent findings.
With Octagos:
- Urgent findings are returned within one hour
- Routine transmissions are returned within 24 hours
- Clinical review occurs within those turnaround windows
These service levels are designed to give practices a predictable workflow even as monitoring volumes increase.
5. Does every report follow the same structure?
Inconsistent reporting is often invisible until it isn't, a missed field, a skipped check, a report that reads differently depending on who wrote it.
Octagos uses a standardized report structure across every transmission, regardless of manufacturer, reader, or site. Nothing gets skipped, readers move faster, documentation stays billing-ready, and records stay consistent across every location a health system operates.
The peer-reviewed research behind the Two-Brain Approach™ also points to why this matters: technician-only review showed lower sensitivity in part due to inconsistency in completing every field of a comprehensive report. A structured format closes that gap.
For practices comparing platforms, ask:
Does the report format vary by reader, or does every transmission follow the same structure regardless of who reviewed it?
6. How does the remote monitoring platform integrate with the EHR?
EHR integration can determine whether remote monitoring simplifies a workflow or simply creates another system for staff to manage.
Octagos integrations are built in-house, at no cost, with implementation timelines generally ranging from 2 to 12 weeks. Today, Octagos has 250+ live integrations across more than 20 EHR systems.
For a deeper look at what integration should actually accomplish, see Breaking Down Data Silos: The New Standard for EHR Integration in Cardiac Remote Monitoring.
The more important question during an RFP is not simply:
"Do you integrate with our EHR?"
Ask what actually moves between the systems, how billing flows, how staff access the platform, and what manual work remains after implementation.
7. What happens to historical Paceart data?
Changing remote monitoring platforms should not mean starting a patient's record over.
Octagos supports migration of up to 10 years of Medtronic Paceart history, including demographics, device and advisory history, encounters, discrete data, PDFs, and images, at no additional charge.
For organizations evaluating a transition, data migration should be part of the vendor conversation from the beginning.
One example is Lehigh Valley Heart & Vascular Institute, which migrated 7,718 patients on day one as part of its transition from Paceart and integration with Epic.
8. Does remote monitoring connect to the billing workflow?
Clinical work and reimbursement should not exist in completely separate processes.
Octagos can send charges to the encounter and create claims within the EHR, reducing the need for a separate billing handoff.
That makes billing capability an important operational question when comparing platforms:
Does the system simply identify billable activity, or does it help close the loop inside the workflow your practice already uses?
The Lehigh Valley implementation offers a real-world example. After moving to Octagos, the organization increased billing efficiency from 68% to 94% within 90 days.
9. Can practices use their remote monitoring data beyond individual transmissions?
Remote monitoring systems contain an increasingly valuable source of longitudinal patient information.
With Ask Atlas™, clinicians can query their own remote monitoring population in plain language for uses including population health analysis and identification of potential clinical trial candidates.
It is one example of how CIED platforms are evolving from transmission-management tools into broader clinical data platforms.
10. What happens when patients become disconnected?
A scalable monitoring program also has to account for patients who stop transmitting.
Octagos offers dedicated patient engagement support for disconnected patients, including live outreach, troubleshooting, education, and escalation.
That work can otherwise become another responsibility absorbed by an already-busy device clinic.
Connectivity is also a growing industry issue. Our overview of remote monitoring guidelines for device clinics looks more closely at connectivity, alert-based monitoring, and the operational expectations facing device programs.
Building a CIED monitoring program that can scale
There is no single operating model that works for every device clinic.
Some practices want software and prefer to keep clinical review internally. Others need additional clinical, operational, patient engagement, or billing support.
The important question is whether the technology and service model can adapt as patient volume, staffing, and organizational needs change. That is ultimately the more useful framework for evaluating a CIED program: looking beyond individual product features and toward the infrastructure required to operate one at scale.
Organizations evaluating remote monitoring technology should also look at the evidence behind vendor claims. Explore Octagos clinical research and publications for peer-reviewed and real-world data on clinical, operational, and financial performance.
FAQ
What is CIED remote monitoring?
CIED remote monitoring allows cardiac care teams to receive and review data from implanted cardiac devices such as pacemakers, implantable cardioverter-defibrillators, and cardiac resynchronization therapy devices without requiring every device check to occur in person.
For a more detailed explanation of the full process, see How Does Cardiac Remote Monitoring Work?
What should a practice look for in CIED remote monitoring software?
Key considerations include manufacturer support, clinical review processes, alert prioritization, report consistency, EHR integration, turnaround times, data migration, billing workflows, patient engagement, security, implementation requirements, and evidence supporting clinical performance.
How does AI help with CIED remote monitoring?
AI can help analyze and prioritize large volumes of device transmissions, so care teams can focus on clinically relevant information. With the Octagos Two-Brain Approach™, Atlas AI™ prioritizes transmissions by acuity, and an IBHRE certified technician reviews every transmission before it reaches the clinic.
How long does CIED remote monitoring EHR integration take?
Implementation varies by platform and health system. Octagos integrations typically take between 2 and 12 weeks.
Does Octagos support Medtronic Paceart migration?
Yes. Octagos supports migration of up to 10 years of Paceart history, including demographics, device and advisory history, encounters, discrete data, PDFs, and images.
Does a clinician review every transmission in Octagos?
Yes, under the Two-Brain Approach™. Atlas AI™ prioritizes the transmission, and an IBHRE certified technician reviews it before it reaches the clinic.