Hi Hole and Billy,
There is no simple answer because like the saying goes, there's more than one way to skin a cat. N_Jay touched on it but basically there are so many ways to interconnect including believe it or not the Internet the issue is simply too complicated to give any sort of an answer.
Just something worth mentioning, hams have something called IRLP, the Internet Repeater Linking Project. I can send a series of DTMF tones to a local repeater and link it to another so equipped just about anywhere in the world. Just think, it all started in the 30s more or less with the telephone patch. Hams quickly caught on to the fact a transmitter and receiver could be connected to a telephone line and the police picked up on it. In the old movies you'd sometimes see the chief sitting at his desk talking on the phone to officers on patrol through the switchboard in the radio room. Now it's all done mysteriously with the push of a button on the dispatcher's console.