This inaugural July 2017 issue of Mayo Clinic Proceedings: Innovations, Quality & Outcomes (MCP:IQ&O)—an open-access, online-only journal—represents a natural extension of contemporary Mayo Clinic Proceedings (MCP) publication practices.1 The purpose of this editorial is to set forth the mission of the new journal, the rationale for its creation, and its scope and positioning in the scientific publishing landscape. I also highlight the key aspects of the operations of MCP:IQ&O and the challenges and opportunities that we see for this new journal.