Abstract: Remote monitoring (RM) is central to care of patients with cardiovascular implantable electronic devices (CIEDs). However, because RM care presents a large and increasing clinician workload, solutions are needed to increase care efficiency. The Veterans Health Administration National Cardiac Device Surveillance Program (VHANCDSP) is a response to this need by centralizing RM processes, reviewing all RM transmissions, identifying patients affected by recalls, and providing guidance on clinical response for 122 VHA CIED clinics across the United States and Puerto Rico. The VHANCDSP promotes participation and adherence in RM, ensuring evidence-based care. The centralized infrastructure also positions the VHANCDSP to evaluate and implement quality improvement interventions, ultimately enhancing clinical care for patients with CIEDs. This article describes and reflects on this infrastructure and provides specific recommendations about how high-quality RM care can be provided in care other health care systems. © 2025