We present an observational study that was conducted to guide the design of an enhanced collaboration platform to support distributed multidisciplinary team meetings between two hospitals. Our goal was to find out how the breast cancer multidisciplinary team collaborates in their face-to-face meetings and in their discussions using an existing videoconferencing system and to identify obstacles and issues to their primary tasks. We identified a set of concerns around the way visibility and audibility affect the social cohesion of the group and impede communication and situation awareness between the distributed team. We also identified a parallel set of concerns around the difficulty of preparing and interacting around the medical images used in the meetings. These issues exposed a complex matrix of technical, social, procedural and organisational factors that affect the collaboration. We suggest potential directions for technical interventions in this setting