A method for operating a system for management of implantable medical devices, IMDs, comprising: conducting, by the system for management of IMDs, communication sessions with a plurality of clinician programmer devices while the clinician programmer devices are engaged in respective programming sessions with IMDs; signing, by the system for management of IMDs, first validation data for first programming data with keys corresponding to respective IMDs; communicating the first signed validation data from the system for management of IMDs to corresponding clinician programmers for communication to respective IMDs to cause the IMDs to conduct therapeutic operations according to programming data validated by respective instances of validation data; receiving and storing, by the system for management of IMDs, second programming data from one or more clinician programmer devices of the plurality of clinician programmer devices, wherein the second programming data was previously created by the one or more clinician programmer devices during programming sessions with IMDs without network connectivity to the system for management of IMDs; conducting, by the system for management of IMDs, communication sessions with patient controller devices for a plurality of IMDs that were programmed with the second programming data; reconciling, by the system for management of IMDs, programming of the plurality of IMDs that were programmed with the second programming data with data stored by the system for management of IMDs; generating, by the system for management of IMDs, second validation data for instances of the second programming data with keys corresponding to respective IMDs; and communicating, by the system for management of IMDs, the second validation data to cause IMDs to conduct therapeutic operations according to programming data validated by respective instances of second validation data. conducting, by the system for management of IMDs, communication sessions with a plurality of clinician programmer devices while the clinician programmer devices are engaged in respective programming sessions with IMDs; signing, by the system for management of IMDs, first validation data for first programming data with keys corresponding to respective IMDs; communicating the first signed validation data from the system for management of IMDs to corresponding clinician programmers for communication to respective IMDs to cause the IMDs to conduct therapeutic operations according to programming data validated by respective instances of validation data; receiving and storing, by the system for management of IMDs, second programming data from one or more clinician programmer devices of the plurality of clinician programmer devices, wherein the second programming data was previously created by the one or more clinician programmer devices during programming sessions with IMDs without network connectivity to the system for management of IMDs; conducting, by the system for management of IMDs, communication sessions with patient controller devices for a plurality of IMDs that were programmed with the second programming data; reconciling, by the system for management of IMDs, programming of the plurality of IMDs that were programmed with the second programming data with data stored by the system for management of IMDs; generating, by the system for management of IMDs, second validation data for instances of the second programming data with keys corresponding to respective IMDs; and communicating, by the system for management of IMDs, the second validation data to cause IMDs to conduct therapeutic operations according to programming data validated by respective instances of second validation data.