Background: The onset of the coronavirus disease 2019 (COVID-19) pandemic changed the landscape of oncology practice and placed tele-oncology at the center of cancer care delivery. As tele-oncology will likely remain a key part of cancer care delivery, healthcare organizations need to determine how to implement tele-oncology programs. We conducted an instrumental case study at a National Cancer Institutes -designated comprehensive cancer center that successfully implemented tele-oncology. Methods: Data were collected from three sources between June 2020–February 2022. We conducted semi-structured interviews among stakeholders directly involved in implementing and/or managing tele-oncology and surveys of administrators of the center’s tele-oncology and clinicians who used the program. Document analysis of implementation deliverables were also analyzed. Data collection and analyses were guided by the Consolidated Framework for Implementation Research, and Clinical Transformation in Technology. We used the Implementation Research Logic Model (IRLM) to develop a framework depicting determinants and key steps for implementing tele-oncology. Results: We interviewed 40 clinicians. We also invited 364 employees to complete online surveys, of which 151 (41.5%) responded. Most respondents were physicians (41.7%), nurse practitioners (26.5%), or physician assistants (26.5%). To implement tele-oncology program, three elements should be considered: (1) platform, (2) people, and (3) process. We found hospitals should: 1) adopt a safe and adaptable platform to deliver tele-oncology; 2) build a multidisciplinary tele-oncology team to provide the administrative, legal, workflow, and clinical support; 3) provide training and resources to make sure all the team members can deliver their responsibilities; 4) identify and appreciate early adopters, departments, and clinicians with successful experiences; 5) frequently evaluate the clinical and implementation outcomes; 6) secure reimbursement comparable with in-person rate and ; 7) advocate for policies that are supportive of tele-oncology in the future. Conclusions: Using IRLM we presented the tele-oncology implementation framework that can be used by hospitals around the world to implement their own tele-oncology.