Poor contextual fit is a significant cause of health information technology (HIT) implementation issues. While the need for better fit of HIT and context has been well described there is a shortcoming of approaches for how to do it. While the diversity of the contexts where HIT is used prevents us from designing HIT to fit all contexts, if we had better ways of understanding and modelling contexts we could design and evaluate HIT to better fit contexts of use. This paper addresses the above need by developing a framework consisting of a set of terminology and concepts for modelling contextual structures and behaviours to support HIT design. The framework provides a way of binding contextual considerations to allow us to better model contexts as part of HIT design and evaluation.