The 2022 merger of Charlotte, N.C.-based Atrium Health and Advocate Aurora Health, then dually based in Downers Grove, Ill., and Milwaukee, created one of the largest nonprofit health systems in the country in Advocate Health.

“We are poised to push past traditional geographic and care delivery boundaries to create a healthier tomorrow for all,” Charlotte, N.C.-based Advocate Health CEO Eugene Woods said at the time.

Now operating as one entity, the 69-hospital system has more than 162,000 employees and provides care for about 6 million patients across Alabama, Georgia, Illinois, North Carolina, South Carolina and Wisconsin, with Winston-Salem, N.C.-based Wake Forest University School of Medicine serving as the system’s academic core.

Almost three years since the merger, Advocate has tapped two leaders to build a national cancer service line. A daunting task on its own, the service line aims to serve as a replicable care model that establishes a blueprint for providing standardized — and exceptional — specialty care at scale.

Ruben Mesa, MD, and Nike Onifade will lead the Advocate Health Cancer National Service Line as president and senior vice president, respectively. Theirs is a partnership balanced with clinical and administrative experience, with both having spent time at the leadership helm of cancer centers across the U.S.

Dr. Mesa and Ms. Onifade spoke to Becker’s about their plans for the unified cancer service line, the challenges and advantages brought on by such an expansive system footprint, and what it means to create “The Advocate Way.”

The case for a national cancer service line

“What I’ve learned along the way is that cancer is not only healthcare, it is a mission. And cancer has been a strong part of the mission for our institution as it’s come together,” Dr. Mesa said.

Each year, Advocate Health cares for about 50,000 newly diagnosed cancer patients in addition to cancer patients already in the system, “making it a very significant activity and area of focus — from research, practice and education,” he said.

Atrium Health’s Wake Forest Baptist Comprehensive Cancer Center, which Dr. Mesa has led since 2023, is one of only 57 NCI-designated comprehensive cancer centers in the U.S. He carries a wealth of insights from his time as executive director of the Mays Cancer Center at the UT Health San Antonio MD Anderson Cancer Center, and as deputy director and chair of hematology and medical oncology at the Mayo Clinic Comprehensive Cancer Center in Phoenix.

“The origin of the service line is really around the concept of: How do we really work together as one system to decrease the burden of cancer in our communities?” Dr. Mesa said. “And then, how do we bring the innovations, clinical trials and expertise of the system to our patients in a way that is both aligned but also a platform for innovation across the system?”

The answer will be found through what Ms. Onifade calls establishing “The Advocate Way.”

“Fifty-thousand new cancer patients each year, that’s a tremendous number,” Ms. Onifade said. “We feel it’s not just a privilege but also a responsibility for us to align and elevate the way we deliver cancer care across our footprint and the system.”

Ms. Onifade’s administrative background is firmly planted in oncology, having served as division vice president of the oncology service line for both Houston-based St. Luke’s Health, a member of CommonSpirit Health, and the Dan L Duncan Comprehensive Cancer Center at Baylor College of Medicine, also in Houston, as well as senior director of operations at Pittsburgh-based UPMC Hillman Cancer Center.

“Ruben and I have spent a lot of time traveling to the various regions we now oversee, seeing how care is delivered,” she said. “We’re meeting people who are incredibly passionate about their work and about finding the best ways to care for patients. Their passion is unique to their local markets; it is also tied to our enterprise focus.”

Balancing local and national needs

As Dr. Mesa and Ms. Onifade navigate how to standardize “The Advocate Way” across six states with diverse patient populations and geographic considerations, prioritization has emerged as a key classifier.

“When we talk about our size and scale — we’re taking care of patients from the South Side of Chicago, to rural Wisconsin, to suburban Georgia,” Ms. Onifade said.

“While there are very important things for us to align around, [alignment on] other things might be more neutral and [misalignment] on others that might be detrimental,” Dr. Mesa said. “The process of identifying what falls in each bucket is important.”

Dr. Mesa envisions a “team of teams” model, where innovation can occur alongside clinical requirements and expectations. The standards that must remain aligned across the Advocate Health footprint are quality, safety, service and patient experience.

“Whether a patient presents in Green Bay, Wisconsin, or Greensboro, North Carolina, their expectations around receiving a certain therapy for lymphoma should be the same, as should their access to our clinical trials or the best of our supportive care,” he said.

“We want patients to get the highest level of care within their home state or city, without needing to fly to a quaternary hub for more complex care,” Ms. Onifade said. “But we also want to leverage the amazing things happening in the communities and provide care curated to that particular community.”

Developing a national cancer workforce at scale

Patient care metrics, quality and safety are not the only elements Dr. Mesa and Ms. Onifade are aiming to align across the system. They also consider unifying the oncology workforce as a crucial component to establishing “The Advocate Way” across the national service line.

“Right now, our Atrium teams feel very connected, our Advocate teams feel very connected, and our Aurora Cancer teams in Wisconsin feel very connected,” Ms. Onifade said. “Our goal is to bring all of that engagement together under the national service line [and maintain] this community and culture of support.”

Dr. Mesa said he has seen how important it is for organizations to have established engagement structures to maintain the passion and purpose of care teams. He foresees supporting the oncology workforce through training and development opportunities such as tumor boards or specialty councils, as well as initiatives that foster a sense of both local and national community among colleagues.

“It’s incredibly important to leverage the fact that we have very dedicated, passionate people who love caring for patients, and give them the resources and tools to continue being successful in their roles,” Ms. Onifade said.

A mission for all

Unlike a standalone institution, Advocate Health’s national cancer service line has system and primary care integration built into its care model.

Driven by the diversity of its patient population and the system’s overall commitment to clinical innovation, Dr. Mesa and Ms. Onifade said the lessons they learn while establishing the national cancer service line will have broad applicability for other health systems.

“The 50,000 new patients we see, when we compare that with socioeconomic data as well as the types of cancers represented, is a fairly accurate reflection of the national data published by the American Cancer Society,” Dr. Mesa said.

“And there is an element of cancer in every specialty and every disease group,” Ms. Onifade added. “You can have cancer in orthopedics, in cardiology, in pediatrics.”

“[The Advocate Way is] really a ‘for all’ mission,” Dr. Mesa said. “Regardless of our role in that mission, we will bring the same passion and purpose that we would if our loved one were the person experiencing cancer.”

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