The paper describes a methodology to improve the scalability support of an embedded bit stream, generated with a wavelet-based compression algorithm, and a generic protocol to handle multiple regions-of-interest (ROIs). The generic scheme, illustrated for embedded zero-tree wavelet (EZW) coding, exploits the inherent graceful degradation capabilities of wavelet-based compression methods and ensures an optimal trade-off between the image reconstruction quality and the compression ratio. Additionally, an efficient protocol is proposed to handle multiple ROIs in an interactive client-server set-up for telemedicine applications. The processing of the ROIs takes place in the wavelet domain.