In modern healthcare, breakthroughs are often measured in technology, new tools, new treatments, new data. But increasingly, attention is turning to a more fundamental question: how care itself is delivered.
Dr Russell Hales, radiation oncologist and Chief of Centers of Excellence at Johns Hopkins Aramco Healthcare, sat down on the sidelines of WHX in Dubai held in February to talk to Gulf Business about medicine, teams and the institution he has been building since joining JHAH in July 2025.
The conversation was anchored by an announcement: the formal launch of JHAH’s Cardiovascular Center of Excellence in Dhahran, Saudi Arabia, the institution’s second Center of Excellence, following the Oncology CoE, and a milestone a decade in the making. His central argument, made quietly and repeatedly throughout the exchange, was that the most transformative thing in medicine right now is not the technology. It is the team.
Johns Hopkins Aramco Healthcare, JHAH, was established in 2014 as a joint venture between Saudi Aramco and Johns Hopkins Medicine. The logic of the partnership is straightforward: one of the world’s largest energy companies, with a medical services operation dating to 1945, combined with one of the world’s most respected academic health institutions. The result is a healthcare system built initially to serve Aramco employees and their families, and now, in a significant expansion, opening its facilities to the wider Saudi public for the first time.
Dr Hales spent 25 years at Johns Hopkins Medicine in Baltimore, 15 of them on the faculty, before making the move to Saudi Arabia. He is the kind of person who talks about patients the way other people talk about family, and it comes through quickly. “When I was asked to come out and be part of this,” he says, “I was given a primary task: to make Johns Hopkins Medicine outcomes and patient experience occur right here at Johns Hopkins Aramco Healthcare. I’m happy to say we’re well on our way.”
The route there has been tangible. Last year alone, the progress has been tangible. In the past year alone, Johns Hopkins Medicine teams delivered nearly 120 assessments, many involving clinicians and other subject matter experts from Baltimore, spending days or weeks working side by side with JHAH staff in Saudi Arabia. “That degree of mentorship, of collaboration, of knowledge transfer,” Hales says, “is at the heart of the excellence that we’re about. This goes beyond sharing protocols. It’s about relationship building between different parts of the world, all under the same umbrella of outstanding medical care.”
Why cancer and heart disease
The decision to anchor JHAH’s Centers of Excellence in oncology and cardiovascular medicine was not arbitrary. It was, Hales says, a direct response to the data. Cancer and cardiovascular disease, including stroke, are the two primary drivers of mortality not only in Saudi Arabia but across the wider Middle East.
According to JHAH, projections suggest more than 479,500 Saudi citizens will be living with cardiovascular conditions by 2035, more than double the current patient population.
The Cardiovascular Center of Excellence has been modelled directly on the Johns Hopkins Heart and Vascular Institute in the US, bringing its protocols, its team-based model and its evidence base to Dhahran.
“For many patients, accessing the right heart care has often meant a choice between travelling abroad or not receiving it at all,” Hales says. “Our Center of Excellence intends to change that, bringing trusted care closer to home, in collaboration with Johns Hopkins Medicine.” In line with Saudi Vision 2030’s healthcare transformation goals, the centre is designed to reduce the need for medical travel, strengthen local specialty capacity and increase private-sector participation in the kingdom’s health system.
What a Center of Excellence actually means
Hales pauses before answering a question about what distinguishes a Center of Excellence from any other well-resourced hospital department. He has, he says, spent a great deal of time thinking about this, partly because the phrase is everywhere. “Everybody loves to throw Centers of Excellence next to their hospital, their brand, whatever you want to call it. But we need to define what it actually means.”
His definition is precise: excellent patient outcomes, delivered with compassion, using the best available technology, by teams and not individuals. The model he describes is a direct challenge to the traditional architecture of hospital medicine, where a patient moves from department to department, seeing one specialist, then another, hoping those specialists have communicated in between. “That fragmented way of delivering care will never answer the promise of medicine,” he says.
He offers breast cancer as an illustration. Historically, an early-stage diagnosis sent you to a surgeon. An advanced diagnosis sent you to a chemotherapy doctor. Today, regardless of stage, a patient at a Center of Excellence will see a medical oncologist, a radiation oncologist, a surgeon, a reconstructive surgeon, a nutritionist, a survivorship expert and a rehabilitation specialist, potentially in the same visit, certainly as part of the same coordinated team. “What that means is patients can come into our clinic and see a team of doctors together, instead of one doctor one day, another doctor another day, hoping they will have communicated in between appointments.” The word wraparound comes up several times in conversation. It is not a marketing term. It is a structural description.
This model, he argues, is also how the full potential of precision medicine gets unlocked. “The biggest way that healthcare has changed is what I would call precision medicine, the idea that one size really doesn’t fit all, that every therapy can be tailored to the patient themselves. If you have cancer, we can now do a genetic analysis of your tumour and identify thousands of pathways that can be targeted. That requires robust AI algorithms. But it also requires teams that can harness that capability for the benefit of each individual patient.”
Beyond the Aramco campus
One of the most consequential shifts underway at JHAH is the move to commercialise, to open the institution’s facilities and expertise to people with no connection to Aramco. This is a structural change, not a marginal one. For the first time, JHAH is partnering with government agencies, participating in population health programmes, and making its two Centers of Excellence available to patients across the Eastern Province, throughout Saudi Arabia and from neighbouring countries.
“Our job as a healthcare institution is not just to care for those that are employed by Aramco,” Hales says. “The charge we’ve been given is to make a difference to every person, not just the people that happen to be employed by Aramco. Population health is something we now do in local communities.” That shift carries real implications for access. The cardiovascular and oncology centres are now open to all. Future Centers of Excellence, Hales declines to name specialties but confirms the strategic plan exists, will follow.
The human element
The most unexpected part of the conversation with Hales is not the clinical detail or the institutional ambition. It is the moment he sets the technology aside entirely. Asked what excites him most about medicine right now, he reaches back to a BASF advertising slogan from his childhood: we don’t make the product, we make the product better. “There is all sorts of technology, all sorts of exciting things happening. But I fear that our ability to percolate that down to patients is not happening in a way it needs to. What excites me most, and what my career has been based on, is developing teams that can unlock the full potential of the technology before us. I am about human engineering. That, to me, is the most exciting thing, because it unleashes everything else available in medicine for our patients.”
He spends roughly half of each working day in mentorship, meeting with clinical leaders across JHAH and helping them become more effective. He is a radiation oncologist who chose his specialty in part, he says, because it requires optimism. Oncologists must be. “Every day is different. I don’t have all the solutions, but the people who surround me do. My job is to help the organisation come up with solutions to the problems that we face.”
His prescription for governments and policymakers is consistent with the philosophy he applies to his own institution. Early detection. Prevention. Investment in cancer screening, diabetes prevention, obesity and weight management programmes. “They’re inexpensive. They don’t cost a lot. And they have so much return on investment that they are the promise of medicine, preventing disease before it ever starts.”
The statement announcing the Cardiovascular Center of Excellence went out the same week as WHX closed. The second Center of Excellence is open. The third is in the strategic plan. And Hales, eight months into a role he came to build from the ground up, sounds very much like someone who has just reached the end of the beginning.
