The PagerDuty step in Bitrise allows developers to run end-to-end tests for their apps every couple of hours as a system health check, ensuring operational issues and incidents are handled immediately. This integration enables the setup of alerts with metrics on system uptime and advanced alert policies, allowing for more efficient issue resolution. Additionally, PagerDuty's on-call scheduling feature distributes workloads while providing 0-24 coverage, safeguarding businesses from potential disruptions.