The right care, at the right time

Dr Peter Mills, Associate Medical Director of Cigna Europe, discusses his interesting journey to this role, highlights global health challenges, and shares his wish for improved focus on ensuring people get the right care, at the right time and in the right place.

Could you provide an insight into your background?

I started off as a regular doctor, training in medicine at the Royal Free Hospital School of Medicine in London, UK, and worked in a variety of hospitals doing the usual junior doctor rotations before specialising in respiratory diseases. At the end of the ‘90s I became very interested in technology; this was during the original dot-com boom and the idea of digital in such an analogue industry was pretty much laughed at. I was fascinated, however, by the internet and could really see the opportunity to transform the way we acquired knowledge and subsequently researched things. The big question though at this time was 'how can we bring technology and health together?'. With a broad vision, I was involved in starting a company called vielife, which provided digital health solutions designed to improve the health and wellbeing of businesses and their workforce. The company had some success in the US and Europe and was subsequently acquired by Cigna in 2006 who were in the marketplace for a solution. I joined Cigna also at this time, and I now work as Associate Medical Director for Cigna Europe. I think it’s important to maintain my roots, though, and still practise as a physician one day a week. I’m currently working at the Whittington Hospital in London, focusing mainly on the treatment of tuberculosis.

We are still stuck in a very reactive state – we get sick, we fix it and the insurers pay out.

What are your current research interests?

I’m particularly interested in population health and how, as a nation, we can be more proactive with health issues. We are still stuck in a very reactive state – we get sick, we fix it and the insurers pay out. With increasing global populations and healthcare expectations I see real opportunities to utilise technology, digital, mobile and genetics to understand the various health risks and put in place approaches to help deliver solid solutions.

Can you discuss your role at Cigna?

I am the clinical director for Cigna Europe, and responsible for the medical management of the UK and Spanish domestic and European corporate books of business. This involves overseeing a team of doctors and nurses who provide clinical support and guidance for our 

We need to find new and innovative ways of treating and curing conditions, and unfortunately these things take time and money.

customers wherever they are accessing care in the world. If an individual is unwell and requires care there are many different things for them to deal with, and our role is to support them through this. But it’s not just about accessing the care; our nurses also provide support and guidance as our customers go through their treatment. If a person is going through cancer or cardiovascular disease, for example, their whole world has been turned upside down. We help them and their family through the emotional upheaval as well as the physical side of the illness. Today, I’m dealing with the child of a globally mobile employee who has psychological health issues and looking at where in their host country would be the best to help them. No case is ever the same, but that’s what is enjoyable about it. I also look after a non-clinical team, the people that work behind the scenes to guarantee payment to our care providers around the world. It’s a very complex role due to the countless global healthcare systems that we are faced with, so this  team must be extremely knowledgeable and up to speed with an ever-changing healthcare system. The final part of my role is to manage the global medical assistance part of Cigna, which involves a team who work on-call, 24/7, to support individuals who become acutely unwell in a location that perhaps doesn’t have a good level of care. For example, someone who may become involved in a road traffic accident or develops respiratory problems and they are based in Iraq or Afghanistan. We would step in to ensure they are moved to a centre of excellence, which could involve mobilising an air ambulance.  It’s a big responsibility and you must be sure it’s always the right thing to do.

What do you see as the key challenges facing European healthcare, and how can these be tackled?

The challenge is worldwide; how do organisations, nations, taxpayers, whoever the funder may be, continue to provide good-quality coverage to populations, while maintaining affordability. The costs of delivery are rising considerably, more than corporate or industry wealth, and this is a real challenge. We need to find new and innovative ways of treating and curing conditions, and unfortunately these things take time and money. This sits high on our agenda at Cigna, and we are continually looking at how we can manage costs more effectively. A lot of this will involve developing closer relationships with providers and ensuring we are more aligned to package up common complaints, such as routine knee replacements. If we can provide that ‘up-front’ visibility, it will drive quality from providers and help us as a leading provider of health benefits and services across Europe to offer better affordability. Can you discuss some of the innovative healthcare solutions you have been involved in creating and what their impact has been? My involvement in the digital health ‘revolution’ back in the ‘90s is definitely a career highlight. It was fun and exciting, and really satisfying. I was involved in a team that essentially pioneered one of the first digital health management solution companies, and to be able to then take that to Cigna, a company who shared that vision and who continue to embrace new technology, has been a great journey.