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Objective: To implement a computerized system to gather and transmit medical record information from six sites to a centralized database for two cancer prevention studies. Methods: Microsoft Access 97 was selected as the application for the system. Sites purchased Access and hardware meeting technical specifications required for the system. A developer worked with the lead investigator and medical record abstractors to develop a 'back-end' database to hold the desired data while maintaining a user-friendly 'front-end' interface. Abstractors trained on a paper version of the abstraction form were then trained to use the system. Meeting minutes and technical notes were used in summarizing the approach and process. Observations were collected through discussions. Results: We overcame multiple obstacles to develop computerized systems supporting medical record data collection at multiple sites. Although system development slowed implementation of the study, the system produced data for cleaning and analysis immediately. Overall the approach decreased the time from study implementation to manuscript submission. Development time for a second system was substantially reduced. Conclusions: Computerized systems for medical record abstraction at multiple sites convey substantial benefit. We present a schematic approach to facilitate development of similar systems in the future.