Introduction: Home care is an important component of the patient-centered continuum of care. Effective home care can help patients recover and recuperate successfully. Furthermore, it can reduce healthcare costs by preventing some of the avoidable and costly acute care and emergency services. Home health agencies (HHAs) providing home care can greatly benefit from adopting health information technology (IT) solutions such as electronic health records. However, HHAs experienced eligibility problems in receiving incentives under the recent HITECH act, and they have limited resources to invest in health IT. Therefore, it is important to create the maximum value possible for the organization by ensuring that health IT addresses the correctly identified and prioritized challenges and opportunities to reduce costs, improve the quality of care, and optimize health outcomes. It is also necessary to maximize efficiency, reducing the overhead costs by addressing the contextual determinants of health IT adoption in HHAs. To obtain and categorize evidence about the challenges and opportunities of HHAs and the contextual determinants of HHAs, we conducted a qualitative study of health IT adoption in Maryland HHAs...