# Reframing EHR Policy in China: Towards Balanced Implementation and Ethical Foundations

## TL;DR

This paper analyzes China's EHR policies using a policy tool framework to guide better implementation and ethical development.

## Contribution

The study introduces a three-dimensional policy tool analysis framework to evaluate and improve China's EHR system policies.

## Key findings

- Authority tools are most frequently used in EHR policies, especially for healthcare quality and innovation.
- Economic tools are underutilized despite their relevance to resource allocation objectives.
- The study recommends balancing policy tools and addressing ethical concerns for improved EHR implementation.

## Abstract

Electronic Health Record (EHR) systems are a core component of healthcare informatization, playing a crucial role in the development of digital and smart healthcare. This study utilizes policy tool theory to analyse policies related to China's EHR system. By gaining a deep understanding of the mechanisms of policy impact, we believe we can better guide the development direction of EHR systems, optimize resource allocation, and improve system effectiveness and efficiency. Ultimately, this will make a substantial contribution to the construction of healthcare informatization.

The research employs Christopher Hood's ʻNATOʼ model of policy tools to construct a three‐dimensional analytical framework. A total of 427 relevant policy documents were retrieved and screened from the PKULAW.COM and WWW.GOV.COM databases. NVivo 14 software was used for text mining and quantitative analysis.

The study reveals that authority tools (36.88%) dominate across most policy objectives, particularly in improving healthcare quality and promoting technological innovation. Nodality tools (27.90%) also demonstrate significant influence in enhancing healthcare quality and fostering technological innovation. Organization tools (21.75%) reflect governmental efforts in institutional development and organizational coordination. While economic tools (13.48%) show a lower overall frequency of use, they are applied relatively more in objectives related to rational resource allocation.

Recommendations include optimizing the government's role and balancing the use of authority tools; refining the policy objective system with increased attention to ethical issues; and strengthening the synergistic application of policy tools to enhance policy implementation effectiveness.