In December 2022, Atrium Health and Advocate Aurora Health combined to form Advocate Health, now the third-largest nonprofit health system in the U.S. But for CEO Gene Woods, the merger was about more than expansion. From the outset, the organization set out to become what he calls an integrated platform for transformation — designed to standardize best practices across a national footprint serving nearly 6 million patients across six states, spanning 69 hospitals and more than 1,000 care sites.
That platform also extends beyond clinical operations. Advocate Health has prioritized addressing key drivers of health and advancing research, development and innovation through The Pearl, a Charlotte, N.C.-based innovation district launched in 2025. The Pearl is home to Wake Forest University School of Medicine’s Charlotte location — the city’s first four-year medical school — as well as the exclusive North American headquarters of IRCAD, a global surgical training and research institute.
“We actually took a page from Florence during the Renaissance,” Mr. Woods said. “… Proximity and creative tension sparked ideas that transformed the world.”
In this conversation, Mr. Woods discusses how that platform mindset has shaped leadership priorities and resource allocation, the guardrails guiding Advocate Health’s expansion of AI, and how the system works to balance speed, risk-taking and accountability while staying connected to front-line insights across a workforce of nearly 170,000 members.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: You’ve described Advocate Health as an “integrated platform for transformation” rather than just a health system. What does that unlock in terms of leadership priorities, resource allocation or how you define success at scale?
Gene Woods: When I refer to us as an integrated platform for transformation, it goes back to the conversations we had when we first came together. From the beginning, we were intentional about creating a new category of health system, which we called an Integrated National Health and Learning Platform, or INHLP. There was real purpose in that idea.
We serve 6 million patients across six states, from Chicago to Alabama, and for us, it was never enough to simply integrate back‑office functions. That said, within 36 months we did standardize our entire infrastructure, including moving to one ERP and one unified standard of Epic, which helped us deliver more than $1.5 billion in efficiency synergies. But our focus was always broader: standardizing best practices across our entire national footprint, addressing the key drivers of health and — through the integration of Wake Forest University School of Medicine — leveraging our platform for research, development and innovation.
This INHLP approach ultimately drove the creation of our Rewire 2030 strategy, which we launched last year, and it now shapes many of our priorities. For example, we have established a single Institutional Review Board with access to 69 hospitals and more than 1,000 care sites. We’ve also launched a National Center for Clinical Trials designed to work with biopharma companies so that we can accelerate the discovery of breakthroughs, participate in the latest trials and bring them to patients in our most rural to our most urban markets.
We created national service lines in oncology, neurosciences and heart, each led by a single physician-administrative dyad, allowing us to align standards and outcomes across the system. In addition, we built a unified virtual care platform for the entire enterprise. This year alone, we reached 150,000 annualized virtual primary care visits, reducing the time to see a clinician from 25 days to same‑day access in many cases. We’ve also used the virtual platform to embed behavioral health into our rural primary care practices, where we serve nearly 1 million patients.
These strategies inform our capital and resource allocation toward future‑ready capabilities that we believe will be critical to long‑term success. And importantly, we’ve kept the main thing the main thing throughout this work. Patient mortality has decreased by 14% despite the fact that we already started from a place of strong clinical excellence. We have also quadrupled the number of Leapfrog “A” hospitals in just the past year.
And because we’ve built financial strength — Moody’s upgraded us to Aa2 — we can keep investing deeply in communities. In 2024 alone, we delivered $6.2 billion in community benefits. That’s $17 million a day going back into neighborhoods we serve, from free care and food assistance to virtual care in 448 schools.
So despite some of the commentary in the field, we have clear proof that, when done right, integrated scale can not only pull together multiplicative talent and capabilities but also drive financial performance and deliver meaningful impact where it matters most: for the patients and communities we serve.
Q: In building The Pearl, you’ve intentionally designed for innovation across disciplines. How do you preserve speed, risk-taking and accountability in such a large, collaborative environment?
GW: Here’s what we’ve learned: You can’t script innovation. You may know part of what’s possible at the start, but the rest emerges through collaboration. When the right people lean in — not just to deliver on a predetermined outcome, but to design and iterate together — you get speed without losing rigor, and you take smart risks that lead to real breakthroughs.
The Pearl is where we’ve located the new four‑year Wake Forest School of Medicine campus, the exclusive North American home of IRCAD — the global surgical training and research institute — alongside leading medtech and robotics partners such as Siemens, Medtronic, Boston Scientific, Stryker and Johnson & Johnson. It was built on the belief that breakthrough innovation happens where disciplines and industries intersect. But those intersections only work if you begin with the right people and the right culture.
We actually took a page from Florence during the Renaissance. That era didn’t flourish because someone wrote a master plan. It flourished because the Medicis created a place where artists, scientists, architects, philosophers and engineers could collide — people like Leonardo, Michelangelo, Galileo and Brunelleschi in their own eras. Proximity and creative tension sparked ideas that transformed the world.
That’s the spirit behind The Pearl. We designed it for purposeful collisions: clinicians working beside researchers, medical students with data scientists, and biotech startups alongside global industry partners. In that environment, accountability becomes natural because everyone can see how their work connects. Speed increases because the time from idea to prototype — or from clinical question to solution — shrinks dramatically. And risk‑taking becomes smarter because diverse perspectives pressure‑test ideas early.
So the way we preserve speed, risk‑taking and accountability in a large collaborative setting is by designing the environment to make those qualities possible. That’s what The Pearl was built for — and we’re already seeing what that unlocks.
Q: As you scale AI from documentation to diagnostics to care delivery, what governance or guardrails are essential to ensure it’s equitable, ethical and clinically meaningful?
GW: As we scale AI from documentation to diagnostics to care delivery, our principle is simple: These technologies must serve as a force multiplier for humanity in care, never a replacement for the human touch. AI should help us anticipate needs, respond faster, improve outcomes and reduce friction for patients and clinicians, not introduce new disparities or risks.
To support this, we established a board subcommittee focused on AI and technology. We believe AI will influence every part of our organization — from care delivery to information security to consumer‑facing strategies — and we wanted to think through the implications of all of this with our board.
We also adopted an extensive, industry‑leading evaluation framework called FAIR AI to assess tools for bias, safety, and clinical relevance before they’re deployed. [Framework for the Appropriate Implementation and Review of AI] helps ensure our AI systems are ethical and — as the name would suggest — fair, as well as valid and reliable, transparent and genuinely impactful for patient care. It has become a core part of how we operationalize responsible innovation.
Even though the field is still new, we’re seeing strong early progress. Across Advocate Health, we now support more than 775,000 clinical encounters each month through AI‑enabled workflows, with more than 75 use cases deployed. Clinician satisfaction is improving, and we’re seeing clearer clinical value.
In imaging, for example, our partnership with Aidoc is enabling radiologists to detect conditions like brain bleeds and pulmonary embolisms in minutes — changes that can mean the difference between recovery and long‑term disability or worse. And our “hospital room of the future” brings together ambient listening, AI‑enhanced cameras, and telehealth to proactively detect risks, allowing for rapid intervention and improved safety, including in rural hospitals where staffing challenges are more acute.
Every deployment is anchored in our mission to redefine care for all, so evaluating how these tools enhance access is part of every deployment strategy. That means asking hard questions to ensure AI expands access rather than creating gaps. It means embedding accountability into every layer of innovation so that speed never comes at the expense of safety. Ultimately, AI should be part of what makes Advocate Health the best place to give and receive care — and that’s the standard we hold ourselves to.
Q: With 170,000 teammates across a merged enterprise, how do you stay attuned to front-line insight? What guides your decision-making as you balance systemwide standardization with local responsiveness?
GW: When you lead an enterprise of almost 170,000 teammates, staying connected to the front line is not just important — it’s essential to making the right decisions. One of the ways we stay grounded is through our operating philosophy: locally engaged, regionally concentrated, and nationally influential. In practice, that means care is always delivered closest to the community, where local leaders know their patients and their needs best. Those local insights flow into our regional structures, where scale strengthens consistency, quality, and resources. And when we see proven models rise from the regions, we lift them across the entire enterprise. It’s a way of listening structurally, not just culturally.
We also begin every major meeting with Connect to Purpose — a moment to spotlight the extraordinary work happening across our hospitals, clinics and communities. It keeps the humanity of care at the center of every decision we make. When you lead with real stories from real teammates and examples of the impact on our patients, you can’t help but stay grounded in the “why.”
Listening is equally core to who we are. We’ve built a culture where teammates feel safe sharing feedback because they know it leads to change. In our most recent teammate survey with 121,000 respondents, 85% of clinicians said that practicing at Advocate Health gives them a sense of accomplishment, a powerful signal that people feel valued, supported and able to do meaningful work.
On a personal level, some of the brightest moments of my week come from dropping into meetings across the system, whether it’s front-line caregivers, support teams or leaders driving local innovation. Hearing them describe what’s working, what’s getting in their way and how they’re solving problems keeps me attuned to the pulse of the organization in a way no dashboard can.
I also believe that having a little fun matters — what Dr. [W. Edwards] Deming called “joy in work.” When people feel connected, supported and able to laugh together, everything gets better: safety, retention, creativity and resilience. That’s why each year we host the Advocate Health Has Talent show, bringing together teammates from across the enterprise. It’s one of the best reminders that talent, heart and humanity sit at every level of our organization.
So in a system our size, the real secret isn’t just listening — it’s making sure people feel heard. When you do that well, the front-line doesn’t just inform your decisions, it helps guide them.
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