The potential for health information technology (IT) to enhance quality of care is limited by unanticipated problems following adoption of new systems and technologies. Proactive assessment of system vulnerabilities can help improve existing systems and ease implementation of new innovations. We applied a comprehensive socio-technical model of safe and effective health IT use to the formative evaluation of a novel tablet-based device designed to support primary care practice in rural India. Based on our conceptual model, we developed an assessment guide for the tablet system that was informed by literature review, interviews, and observations of health workers and supervisors. Our assessment revealed and addressed both technical (functionality, content, usability, user interface) and non-technical (workflow, processes and policies etc.)areas of improvement.