On this episode of the Healthy Wealthy and Smart Podcast, I had the pleasure of welcoming Dr. Kenneth Miller onto the show to discuss patient care transitions between physical therapy settings. Dr. Kenneth L. Miller is a physical therapist and educator with more than 20 years of experience working in home care and inpatient rehab settings, as well as more than 7 years in adjunct faculty roles for the University of St Augustine, New York Institute of Technology, University of Michigan–Flint, and Touro College. He is a clinical educator at Catholic Home Care, in Farmingdale, N.Y., has developed a course on clinical pharmacology for GREAT Seminars and has several online courses for MedBridge. Dr. Miller chairs the APTA's Home Health Section Practice Committee and is a member of the editorial boards of Topics in Geriatric Rehabilitation, GeriNotes, and is a manuscript reviewer for the Journal of Geriatric Physical Therapy.

In this episode, we discuss:

-The current state of information transmission between physical therapy settings

-Biomarkers used to evaluate the health status of patients

-The real risk of patient fragility and the importance of adequately overloading during treatment

-How to enhance home compliance and educate patients through technology

-And so much more!

Information sharing between healthcare settings is often not reliable. Instead practitioners should focus on ensuring they have the most salient information. From Dr. Miller's experience, he states, "It is often difficult to get the information I need. It becomes futile sometimes to try and get that information. Some clinicians have stopped reaching out to hospitals and just try to do the best they can with what they have."

Effective and literature supported biomarkers such as gait speed and distance are useful tools to assess risk of re-hospitalization and guide plan of care. Dr. Miller stresses to, "Get those biomarkers out there, so that way even if we can't get all of the information, be very specific with the type of information, and we can reduce readmissions."

With a growing demographic of home care patients, assessing patient risk level and the need for physical therapy is becoming more important. Dr. Miller notes, "Our patient case loads are going through the roof. I think we need to be able to triage our patients more appropriately for who does need care and who doesn't and try not to make visits that are not necessary."

One of the biggest challenges facing physical therapy exercise prescription is effectively loading patients. Dr. Miller shares that, "The only known way to combat frailty at this point is exercise and it has to be appropriately dosed."

For more information on Dr. Miller:

Dr. Kenneth L. Miller is a physical therapist and educator with more than 20 years of experience working in home care and inpatient rehab settings, as well as more than five years in adjunct faculty roles. He is currently a clinical educator and physical therapist at Catholic Home Care, in Farmingdale, N.Y., and a consultant, for The Corridor Group. He has taught for New York Institute of Technology, University of Michigan–Flint, and Touro College.

He is the co-author of the book Providing Physical Therapy in the Home, published by the American Physical Therapy Association (APTA), as well as the author of peer-reviewed publications in Neurorehabilitation and the Journal of Geriatric Physical Therapy. He has presented at the APTA Combined Sections Meeting and NEXT Conference.

Dr. Miller chairs the APTA's Home Health Section Practice Committee and is a member of the editorial boards of Topics in Geriatric Rehabilitation, GeriNotes, and the Journal of Novel Physiotherapy and Physical Rehabilitation.

He is the recipient of numerous honors, including three APTA Home Health Section awards: 2016 Section Contribution Award, 2015 Outstanding Effort Award, and 2010 Excellence in Home Care Award. In 2012, he received the Shining Star Award from the Long Island Health Network.

He is a Board Certified Geriatric Specialist, a TeamSTEPPS Master Trainer, an APTA Credentialed Clinical Instructor, and an APTA Certified Exercise Expert for Aging Adults.

Resources discussed on this show:

Fried et al. 2001: Frailty in older adults: evidence for a phenotype.

Dr. Kenneth Miller Twitter

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Xo Karen

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