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Description:Telemonitoring TM interventions for the management of heart failure HF has seen limited adoption in Canadian health systems but isolated examples of TM programs do exist. An example of such a program was launched in a specialty HF clinic in Toronto, Canada and a recent implementation evaluation concluded that reducing the cost of delivering the program is necessary to ensure its sustainability and scalability. The objectives of this study are 1 to understand which components of the TM program could be modified to reduce costs and adapted to other contexts while maintaining program fidelity; and 2 to describe the changes made to the TM program to enable its sustainability within the initial implementation site and scalability to other health organizations. Ideas for adapting the program were informed by the interview results and prioritized based on: Five themes representing opportunities for cost reduction were discussed, including: The hardware used for the TM system and the modalities of providing technical support were found to be highly adaptable which supported the decision to implement a BYOD model, whereby patients use their own smartphone, weight scale and blood pressure cuff as well as the development of a website aimed at reducing the burden on a technical support telehealth analyst THA.