INTRODUCTION
The novel coronavirus disease (COVID-19) first appeared in China in the late fall of 2019, and on March 13, 2020, was declared a national emergency in the United States (U.S.) following the World Health Organization’s declaration of a global pandemic two days prior. This event challenged healthcare systems across the U.S. to quickly implement and sustain new ways to see and treat patients, providing both challenges and opportunities for healthcare providers.  A transformative moment for telehealth to become mainstream1, rapid implementation of telemedicine visits became essential to maintain care for patients while keeping them safe during a rapidly spreading pandemic.
While the concept of modern-era telemedicine is not new, prior to the COVID-19 pandemic, telemedicine was infrequently used to provide medical care in urban tertiary care centers. Telemedicine’s relevance in pediatrics had been highlighted by the American Academy of Pediatrics in their statement in 2015 as a care delivery model, educational and research tool2. An analysis of 28 published studies about the use of telehealth did not show strong supporting evidence for its use3.
Similar to many large tertiary care centers, the Children’s Hospital of Philadelphia (CHOP) had some limited experience with telemedicine platforms. Prior to March 13, 2020 and the COVID-19 pandemic, the division of pulmonary and sleep medicine at CHOP had only used telemedicine in a small pilot program. Discussions had occurred more than 18 months prior regarding expanding the use of telemedicine in a subset of patients, but progress was hindered by lack of reimbursement by third-party payers and interstate medical licensure concerns. Our first telemedicine video visits were implemented on March 24, 2020 at the start of the COVID-19 pandemic.
In tandem with our rapid implementation of telemedicine, we conducted a quality improvement study to assess the feasibility, utility and favorability of pulmonary telemedicine visits through the use of provider and patient/family surveys. We hypothesized that telemedicine is an effective and feasible means of providing medical care to children and adolescents seeking pulmonary care and is a favorable option to provide care for children with a wide range of pulmonary diagnoses.