This document addresses telehealth medicine in an effort to improve everyday emergency and disaster preparedness and response capabilities. COVID-19 initiated a foundational transformation for pediatric telehealth. As an alternative to in-person care, telehealth created a socially distanced vehicle to continue to provide care that kept patients at home. In order to both care for their patient population and reduce the risk of COVID-19 exposure, hospitals rapidly embraced and expanded telehealth programs. Long-term plans and investments were implemented in a very short timeframe, with near universal adoption of the technology. Telehealth proved a valuable tool for the specific task of pediatric disaster and surge response across the spectrum of care, including the areas of pre-hospital, rural clinic, community Emergency Department (ED), and children’s hospitals.