Not too long ago, the home was the preferred venue for the delivery of medical care. Then, with the explosion of biomedical knowledge and technology, and the growth of third party and single payer health systems during the 20th century, care shifted to brick-and-mortar facilities – outpatient clinics, hospitals, nursing homes, rehabilitation facilities, urgent care clinics, among others. This shift was not without challenges – facility-based care, especially hospital care, is associated with substantial risk of iatrogenic harm, poor care experience for patients and their family members, significant barriers to access, and high cost that now strains national economies around the world. The provision of care at home, especially medical care, diminished to become a rare, endangered and then largely extinct entity.

However, over the last several decades, advanced home medicine has made a comeback and built an impressive evidence base for models that span what is now an advanced home medicine ecosystem, including hospital at home, home-based primary care, home-based palliative care, mobile integrated health and community paramedicine, remote patient monitoring, home-based integrated medical and social care models, rehabilitation at home, and many others. Leading this charge has been the decade’s long emergence of hospital at home, which saw even wider acceptance starting with the 2019 pandemic. These models developed and were studied in the context of clinical, economic, policy, regulatory, and implementation outcomes that have often been challenging to publish. In most facility-focused health care delivery systems around the world, home medicine remains a countercultural construct, an afterthought, an under or unappreciated stepchild. We believe the time is now to transform our thinking and our practice, with complete focus on advanced home medicine.

There has not been an academic journal that has understood scholarship around care in the home, especially advanced care in the home. JAHM seeks to establish itself among the peer-reviewed, high quality, respected journals of the world. We are a not-for-profit and have achieved both open access for readers and low cost for contributing authors (made possible by our multiple Collaborating Societies, more below). We hope that JAHM becomes a central point for clinicians, researchers, educators, policy makers, family caregivers, and patients who want to learn about advanced home medicine.

The Journal’s name is important and reflects years of debate among many of the leaders of our field. Health care worldwide is headed home, and JAHM will be a big-tent journal, hoping to attract the world’s premier scholarship on advanced home medicine. We fundamentally believe that the home represents medicine’s next frontier, where if we can bring advancements in the right care to the right patient at the right time in the home, we can almost always do better for our patients. Whether high touch or low touch, AI or analog, in-person or remote, we firmly believe that in the future, the best of health care will be found at home.

While we are committed to all efforts to design, test, disseminate, and measure advanced home medicine, our strongest focus is on hospital at home, or the provision of acute hospital-level care at home as a substitute for brick-and-mortar hospital care. This care delivery model has seen rapid expansion worldwide, and we are committed to disseminating the most impressive advances in hospital at home. Stay tuned for future consensus statements from societies worldwide who will endeavor to define hospital at home in their country.

This work takes a village. First, we are proud to call the leading national societies from around the world our Collaborating Societies:

  • American Academy of Home Care Medicine

  • Hospital in the Home Society of Australasia

  • Taiwan Society of Home Health Care

  • UK Hospital at Home Society

These Collaborating Societies support the Journal, and JAHM is the official journal of these Societies. We look in hopeful expectation to other Societies joining this wonderful group. Second, we have a worldclass editorial board who have dedicated countless hours to ensuring a robust peer review process and that we publish the very best advanced home medicine. We are most indebted to them and will find ways to appropriately embarrass them in coming issues. Third, we appreciate the continued work of our Managing Editor, Susan Phillips, who has helped us reach this milestone. Fourth, we congratulate the brave scholars who have entrusted us with their manuscripts for our first issue. In this issue, authors teach us:

  • Ko et al: A standard hospital at home definition for escalation and an international benchmark of about 7% is likely what we should all use.

  • McGlen et al: Over 80 surveys of UK-based hospital at home stakeholders spelled out the facilitators and barriers to hospital at home program launch, namely the digital infrastructure and innovation-friendly governance required to make things go.

  • Oliveira et al: An international survey of the Ibero-American experience in advanced home medicine, highlighting opportunities for standards across the spectrum.

  • Plastino et al: A novel postpartum pathway appears feasible, helps with bed scarcity, and may even cut cost.

  • Richards et al: Multiple hospital at home case vignettes teach us best practices for hospital at home programs, with a focus on person-centered care.

  • Tierney et al: An immediately useful clinical tool for busy hospital at home clinicians to predict the risk of escalation in hospital at home.

  • Vetter et al: The Home-Based Primary Care Learning Network resulted in over 700 plan-do-study-act cycles that the authors summarized and can systematically inform home-based primary care efforts.

  • Whitehead et al: semi-structured interviews with multiple US-based institutions described the trials and tribulations of remote patient monitoring use during hospital at home, arguing for hospital at home-specific quality metrics for remote patient monitoring.

We have dedicated our collective careers to advanced home medicine in all its forms – research, policy, clinical, implementation, innovation, and we are deeply honored to launch JAHM alongside so many of our supporters. Our vision is that JAHM will bring the finest scholarship in advanced home medicine to the world in service to you and our patients. We look forward to your brilliance, your partnership, and realizing the vision of the future state of medical care.

With gratitude,

David, Michael, and Bruce