Cardiovascular service lines are growing fast—and so are the data streams they are expected to manage. The remote monitoring landscape—once confined to pacemakers and ICDs—has diversified to include Holter monitors, MCTs, loop recorders, and FDA-approved wearables. Yet, this proliferation of third-party vendors introduces a critical challenge: each new input demands its own login and workflow, exacerbating system fragmentation.
During a recent webinar hosted by Becker’s Healthcare and sponsored by Murj®, cardiovascular leaders from across health systems and clinical practices explored how their organizations are evolving to adapt to the new reality of remote monitoring.
From subspecialty silos to a single platform
Five years ago, cardiovascular service line strategy was centered on electrophysiology (EP) lab utilization, catheterization lab volumes, and traditional cost-management. But the strategic landscape has evolved, shifting away from purely volume-driven goals toward managing continuous patient data and long-term care delivery.
“We have a lot of cats in the [cardiovascular] service line, so how do you really bring those together under one platform?” said Gordon Wesley, SVP, Chief Strategy and Clinical Integration Officer at University of Chicago Medicine AdventHealth. The service line, he said, has to be reframed as a broader operating platform, with heart failure (HF), EP, and other cardiovascular subspecialties connected within it.
At Atrium Health, a single platform already handles loop recorders, pacemakers, and ICDs. The team is also working to bring Apple Watch and AliveCor tracings into a similar workflow, creating the structure needed to support consistent review, documentation, and reimbursement when appropriate.
Routing the right data to the right team
Consolidating into one platform is only half the problem. Clinical workflows must be adept in routing data to multiple care teams, depending upon the information within the transmission.
“The information that comes in regarding heart failure is not really managed by EP, it’s managed by heart failure,” said Gopi Dandamudi, MD, MBA, Founding President of the Heart and Vascular Institute at Prisma Health. “Right now, we live in episodic value-based programs, but these have to move towards longitudinal value for the care of that patient. I think that’s where the biggest bang for the buck is.”
The path forward, panelists said, depends on EHR integration and workflow design—including the ability to build discrete fields in Epic for HF metrics, so relevant device data lands in the clinical workflow like is commonly done with laboratory test results.
Team-based care for continuous data
Episodic care models are not built for continuous data monitoring. The panelists pointed to team-based care, clear protocols, and defined escalation pathways as the operating model required to manage it.
“Physicians’ time is too valuable to manually process every transmission,” said Troy Leo, MD, MHCM, FACC, Service Line Leader for Heart and Vascular at Atrium Health. Atrium has assembled a multidisciplinary team of pharmacists, nurses, navigators, and advanced practice providers (APPs) who protocolize care or warm handoff patients to primary care or other partners.
Centralization can also protect against single points of failure. At Prisma, device monitoring operates as one systemwide clinic rather than a set of local device clinics, with real-time vendor metrics helping the team understand workload and redistribute work when needed.
Where the revenue leaks
Remote monitoring highlights a critical vulnerability where cardiovascular programs leave money on the table—and the leakage is rarely at the billing end. Instead, it stems from a gap in engagement. Dr. Leo emphasized that when organizations fail to actively pull data or ensure patient transmissions, they lose both clinical visibility and the ability to bill for services. In short, a patient with an undetected hardware issue, such as a faulty lead, represents a fundamental failure in program connectivity.
Shifting to proactive monitoring workflows allows organizations to secure the revenue necessary to fund and sustain their infrastructure. This operational discipline is even more vital under the 2026 CMS code updates, which expand billing eligibility for patients transmitting data between two and 15 days per month. However, the panel emphasized that unlocking this financial potential requires robust upstream infrastructure: seamless connectivity, standardized protocols, and tools that unify data into a single workflow.
The data avalanche
Asked what would matter most over the next five years, the panel converged on several fundamentals: infrastructure, system buy-in, governance, protocols, and a shift from episodic monitoring to longitudinal value.
As wearables and implantables reduce friction between patients and data, the cardiovascular service lines best positioned for the future will be those organized around continuous data, team-based protocols, and clear accountability for action.
“I’ve been an advocate for wearable technology because wearables or implantables remove the friction that’s involved,” said Kenneth Civello, MD, Louisiana Cardiology, FMOL Health. “Once you remove the friction, we’re going to get a data avalanche.”
Navigating this data avalanche and executing team-based care requires more than just a shift in mindset—it demands a robust operational backbone. The panel agreed that without the right systems in place to route, filter, and track this information, even the best protocols will fail.
“At the end of the day, infrastructure wins,” Dr. Leo said. “You may not be able to realize the gains right away, but the ones that invest in infrastructure now are going to be the winners.”
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