​IHI Open School Change Agent Network (I-CAN) Learning Activities



Karen Slone, a 53-year-old diabetic living in Arizona, noticed a sore developing on her foot. But without health insurance, she put off going to the doctor, treating it at home with Neosporin and Band-Aids. When she finally went to the emergency room, reports the Los Angeles Times, her wound was infected. Surgeons removed bones in two toes.

Slone isn’t alone in her trouble accessing care. In the first quarter of 2015, even after the Affordable Care Act took effect, about 12 percent of the U.S. population didn’t have insurance. And uninsurance is just one of many factors that hamper access to care in the US and around the world — distance to health facilities, language barriers, exorbitant costs, and the complexity of the health system can make it difficult for people to access the care they need, causing needless suffering and soaring costs. For example, in some low-income countries, people living in some rural areas can’t afford transportation to health facilities, so they have to reach care on foot — even when sick or pregnant.


Explore our list of IHI Open School resources and activities below to start learning more about issues facing communities as they relate to care access. This list is by no means comprehensive, there are many things we can and should do to improve access but this should get you started on the road to improving health and may even serve as ideas for leading change.

To become a change agent and lead change click here to learn more about I-CAN projects.

​Topic Ac​tivities & Resources Potential I-CAN Projects
Access to clinics and providers
  • Reduce emergency department utilization and inpatient admissions in rural community through health coaching services - Indiana University Purdue University Indianapolis
  • Improve materials and care services to reduce language barriers for patients at local clinics.
High Cost


​Finished the activities and ready to do more? Here are five things you can do to improve the health of your community:

  1. Share your pledge to improve population health.
  2. Make your support visible: Share this with colleagues and friends through your networks and conversations, post on social media (@IHIOpenSchool), and invite others to pledge to take action with us
  3. Lead and become an agent for change by conducting a project to improve care access through the I-CAN course.
  4. Amplify efforts locally by joining an existing I-CAN project or by connecting with your community. Contact us to link up!