The foundations of telemedicine consulting were laid in the 70s of the 20th century. However, development of this direction was significantly accelerated at the beginning of the 21st century. A significant accelerator was the pandemic of a new coronavirus infection (COVID-19). The Russian Federation has federal and regional systems that often develop in isolation from each other. At the beginning of the new coronavirus infection pandemic in the Russian Federation, a vertically integrated model for counseling intensive care patients with COVID-19 and pneumonia was created. Various national and foreign studies confirmed high efficiency of telemedicine counseling for in-hospital patients. This is evidenced by less mortality rates and ICU-stay, as well as introduction of modern clinical practice in regional hospitals. Integration of critical care for children is carried out through critical care advisory support centers based on large regional and federal hospitals. The objective of regional centers is decision-making on the need for hospitalization of patients in level III hospitals, while the task of federal centers is management of patients in accordance with modern clinical practice.