Quality is gaining increased attention in medicine including oncology. This heightened focus on quality is long overdue, as noted by the Institute of Medicine over a decade ago. Unfortunately, medical practice including the numerous disciplines of oncology continues to fall short of its 'quality frontier', an analogous concept to the productivity frontier in business. Diverse but inter-related forces including culture, transparency, personalized medicine, economics and informatics are together driving the practice of oncology closer to its quality frontier. Examples of initial progress in relation to each of these forces are reviewed and their implications for future impact on quality discussed.