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2023 TEXAS LEGISLATIVE
SESSION WRAP-UP

the impact on patients they serve who are uninsured or under-in- gitudinally throughout the residency. Since most trainees simultane-
sured. They see the challenges of working with hospital care naviga- ously do inpatient services, they see the impact of less optimally man-
tors and social workers to get these patients the care they need at aged patients. Further, our social determinants of health SDoH efforts
times. TIGMER and LSOM trainees have the privilege of caring for are aimed at opening residents' eyes to how much other issues than their
patients supported by University Health's CareLink financial assis- care in the clinic or the hospital impacts their patients' health.
tance program. Further, they see the positive impact of the Texas Diabetes and obesity, and their secondary comorbidities, are sig-
Health and Human Services Healthy Texas Women program. The nificant issues for our county. Our LSOM Endocrinology fellows are
TIGMER and LSOM IM residents experience WellMed's Account- involved in research studying the mechanisms of SGLT2 inhibitors
able Care Organization approach to delivery. Residents are on the tip and the effects of ketone elevation in several groups, including in di-
of the spear, seeing the challenges for the un- and underinsured pa- abetes, heart failure and the elderly. Further, they engage in quality
tients navigating the healthcare system. We foresee even greater en- improvement projects, trying to improve all our quality measures in
gagement of this generation on this issue. patients with diabetes, including microalbuminuria, lipids and
screening for NASH to prevent it and decrease the progression of
3. Chronic Disease Management: Bexar County faces a high micro- and macrovascular complications. The LSOM Pediatric En-
prevalence of chronic diseases such as diabetes, obesity and cardio- docrinology Fellowship was actively engaged in enrolling patients
vascular diseases. Improving chronic disease management and pre- into the bionic pancreas trial, an artificial intelligence-powered sys-
2
vention efforts, including increased access to healthcare, regular tem recently cleared by the U.S. Food and Drug Administration.
screenings, health education and lifestyle interventions, can signifi- Both fellowships are serving the underserved at the Texas Diabetes
cantly impact the health outcomes of residents. Institute, making a substantive impact through patient care, quality
Managing patients with chronic diseases is embedded within each improvement endeavors and research.
of the other six categories as are efforts in GME. Continuity Care Clin-
ics are required for all primary care and some specialty residencies and 4. Behavioral Health Services: Access to mental health and sub-
fellowships. These patients with chronic conditions are followed lon- stance abuse services is a critical need in Bexar County. The area
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