Primary care is where the health care system meets the people – the first point of care for the citizenry. General practice and primary care DH&IT tools are essential strategies to strengthen health systems to achieve health priorities and universal health coverage and sustainable development goals. While primary care DH&IT systems are just as if not more sophisticated and innovative as hospital acute care systems, they have historically not received the same attention and funding. This may reflect different organizational models built around episodic care of diseases in hospitals versus continuity of care of undifferentiated health issues in general practice. Medication and disease-specific research studies in hospitals are easier to design and implement compared to study designs for the usually more complex and non-drug interventions used to address undifferentiated health problems in general practice. Primary care research and evaluation is therefore usually a lower priority for public and private research funding. Two IMIA Working Groups (Primary care informatics and Technology assessment & quality development) collaborated on this special issue to highlight these major challenges for ongoing attention.