An implantable medical device, IMD, comprising: therapeutic circuitry for controlling delivery of a medical therapy to a patient; a processor for controlling the IMD according to executable code; wireless communication circuitry for conducting wireless communications; and memory for storing data and executable code, wherein the executable code comprises code for causing the processor to: communicate with an external programming device to receive therapeutic settings data for operation of the IMD and validation data, wherein the validation data comprises temporary validation data generated when network connectivity to a remote device management system is unavailable, perform validation operations on one or more instances of the therapeutic settings data by determining whether a respective instance of the therapeutic settings data is accompanied by the validation data, wherein the validation operations comprise analyzing the validation data against at least one key of a plurality of cryptographic keys stored by the IMD, and communicate with the external programming device or a patient controller device according to a revocation protocol for receipt of available revocation data from the remote device management system, wherein the revocation data identifies one or more cryptographic keys of the plurality of cryptographic keys that are no longer trusted. therapeutic circuitry for controlling delivery of a medical therapy to a patient; a processor for controlling the IMD according to executable code; wireless communication circuitry for conducting wireless communications; and memory for storing data and executable code, wherein the executable code comprises code for causing the processor to: communicate with an external programming device to receive therapeutic settings data for operation of the IMD and validation data, wherein the validation data comprises temporary validation data generated when network connectivity to a remote device management system is unavailable, perform validation operations on one or more instances of the therapeutic settings data by determining whether a respective instance of the therapeutic settings data is accompanied by the validation data, wherein the validation operations comprise analyzing the validation data against at least one key of a plurality of cryptographic keys stored by the IMD, and communicate with the external programming device or a patient controller device according to a revocation protocol for receipt of available revocation data from the remote device management system, wherein the revocation data identifies one or more cryptographic keys of the plurality of cryptographic keys that are no longer trusted. communicate with an external programming device to receive therapeutic settings data for operation of the IMD and validation data, wherein the validation data comprises temporary validation data generated when network connectivity to a remote device management system is unavailable, perform validation operations on one or more instances of the therapeutic settings data by determining whether a respective instance of the therapeutic settings data is accompanied by the validation data, wherein the validation operations comprise analyzing the validation data against at least one key of a plurality of cryptographic keys stored by the IMD, and communicate with the external programming device or a patient controller device according to a revocation protocol for receipt of available revocation data from the remote device management system, wherein the revocation data identifies one or more cryptographic keys of the plurality of cryptographic keys that are no longer trusted.