Collaborative associations between academic medical centers and community hospitals can use telemedicine to promote and enhance cancer treatment and clinical research. It is expensive to duplicate communications technology at all sites, but it is possible to share technologies using telemedicine. This paper describes a system in evolution that provides regional oncology services at the University of Wisconsin Hospital and Clinics and regional oncology affiliates. The system requires integrated hardware and software to provide Internet access, videoconferencing, and data transmission. This system is comprised of several forms of technology that promote education and training, continuing medical education, patient evaluation and protocol eligibility, data transfer for radiation therapy treatment planning, and clinical and technologic quality assurance and peer review programs for medical oncology and radiation oncology.