When the hospital task force was looking for someone to delve into the reams of health-related data they received from Lincoln County Healthcare, Andrew Twaddle didn’t hesitate to offer his services. It was a perfect fit. He has the academic’s natural love of research, and health, sickness and healthcare systems have been a major part of his life for most of his 74 years.

Twaddle’s initial immersion into healthcare was not by choice. His father was the first board-certified cardiologist in Connecticut. Being a doctor’s son gave Twaddle experience with the “culture of medicine” that has been useful throughout his career, he said.

Twaddle completed his undergraduate work at Bucknell University, his master’s at the University of Connecticut and his doctorate at Brown University.

In his doctoral dissertation on medical outcomes, Twaddle defined the “disease-illness-sickness triad,” which he said refocused medical discourse at the time. In-depth interviews with patients and caregivers have been at the crux of his research here and abroad over the last five decades.

Twaddle’s research and academic associations are extensive, including research for the National Institute of Health, Harvard Medical School, the University of Pennsylvania, and for the Swedish government. Twaddle is currently professor emeritus at the University of Missouri.

For all his credentials, Twaddle is an unassuming character. He is soft-spoken, smiles easily and is amenable to an extended discussion on a locally-contentious issue.

Mike Pander, who joined with Peggy Pinkham and Twaddle to form the data work group, calls Twaddle the “data guru.” It’s an apt term. Twaddle’s like the eye of a storm: intensely focused on his work without any display of force.

The healthcare data, as well as Twaddle’s summaries and questions, can be found at the Boothbay Town Office in a bulging three-ring binder. He has summarized the peninsula’s demographic data, data on St. Andrews Hospital, community health needs data from OneMaine Health and other sources, and the Navigant report, which supported the recent hospital decisions.

All of these data sources are separate and for much of the data, such as the Navigant report, there is no narrative to explain how Lincoln County Healthcare used or interpreted the data. Twaddle’s efforts to make sense of these disparate pieces of information have led him to some interesting observations about healthcare on this peninsula.

Twaddle’s conclusions

The demographic data show a rapid aging of the peninsula’s population, which has ramifications for healthcare. “Age carries with it an increased chronic disease burden,” Twaddle said, “We will see a lot more heart disease, cancer, stroke, diabetes, fractures – all the things that come with aging. This needs to be thought about relative to (closing) the emergency room.”

After he reviewed the data, Twaddle concluded that there are a lot of unmet health needs on the peninsula. He thinks a local study is needed to better define those needs.

Twaddle said he was surprised that the St. Andrews Hospital data he reviewed was limited to “mostly financial data and performance and utilization data.” He said Navigant’s market analysis of where patients seek care is an “approach that would underestimate the utility of St. Andrews Hospital and to some extent, Miles Memorial Hospital.”

Twaddle said he didn’t find anything in the data he reviewed that focused on the quality of care. He said there is a difference between technical quality (the level of knowledge, equipment and skill with which care is provided) and quality of care (how a patient feels and their relationship with care providers).

“Quality of care has to do with the patient’s needs being met and not just technical needs. Having a facility where friends and family can visit you is important to quality of care.” Twaddle said. “When you pay attention to the quality of care, the outcomes are better.”

Twaddle said he is also concerned because Navigant refused to disclose some of the methods it used to arrive at data points. Without details on methods, which Navigant told him were proprietary, “you can’t be sure what to make of the data,” he said.

From a broader perspective, Twaddle is concerned about the “corporatization” of healthcare in the U.S and that “business people are making decisions about care.”

“The United States is the only country in the world where non-medical people get involved in medical decisions about what services are offered,” he said.

Twaddle said when healthcare services are looked at in terms of dollars generated instead of patient need, needed healthcare services can atrophy or disappear locally.

Twaddle is, at least for the moment, done with his work for the task force. His findings will be used by the MacDonald work group to develop an alternative healthcare plan for the peninsula that would maintain St. Andrews Hospital. He developed a list of the healthcare services he believes are needed on the peninsula.

Twaddle said despite the unfortunate circumstances, he is really impressed with the task force and its volunteers.

“I’ve never seen a group get this organized, this quickly,” he said.

Sue Mello can be reached at 844-4629 or sumello@boothbayregister.com