Accessing cancer treatment and follow-up care remains challenging for rural patients. Telehealth offers a solution, as seen in Fredericton and Upper River Area, New Brunswick, where over 50% of the population is rural. This study assessed quality improvements in telehealth oncology care through three initiatives: (1) General Practitioners in Oncology conducting rural outreach, (2) integrating rural patients into remote clinic rounds, and (3) enhancing palliative care collaboration. Phase I involved a retrospective chart review of patient records from 2016 (n = 31) and 2019 (n = 38) comparing usual care versus first year intervention group. Most patients were female (58% in 2016, 55% in 2019), with median ages of 63 and 67 respectively. While treatment disruptions were minimal, clinical trial participation remained low, with only one patient enrolled. However, palliative care referrals increased significantly in 2019, improving access to supportive care. Phase II included semi-structured interviews with patients (n = 11) and providers (n = 7). Patients reported reduced stress and logistical burdens with telehealth. While no major technical issues arose, some recommended closed captioning and better camera quality. Providers supported telehealth for most visits but noted limitations in physical assessments and inconsistent nursing and IT support. Palliative care providers emphasized its value, stating, “telehealth means more patients are getting the palliative care they need.” Overall, telehealth has improved rural oncology care access, particularly for palliative care. However, barriers remain in clinical trial participation and technological infrastructure. Future efforts should focus on enhancing virtual care technology, ensuring adequate staffing, and promoting equitable access to telehealth services, especially on the artificial intelligence era.