Background: Electronic health records play significant roles to increase the effectiveness, and efficiency of health system services by creating transparency, decreasing the use of unnecessary services, decreasing medical errors, helping health research, etc. Throughout the years, several laws and regulations regarding electronic health records have been enacted. This research intended to examine Iran's electronic health record implementation policy.

Methods: This study was conducted within the framework of Walt and Gilson's policy analysis triangle. The researchers reviewed Persian and English articles, reports, and studies on electronic health records in Iran from 2001 to 2022 to collect data. The reports of organizations such as the Majlis Research Center, Iran Health Insurance Organization, Social Security Insurance Organization, and Ministry of Health were also studied within the format and framework of Walt and Gilson's policy analysis triangle.

Results: The examination of upstream documents and articles in "policy content" dimension indicated unrealistic and different schedules, the lack of a clear strategy, and proper planning. Furthermore, the main actors of electronic health records included the Ministry of Health, The Information Technology Executive Council, Supreme Council of Health Insurance, the Iran Health Insurance Organization, medical insurance organizations and funds, the Iran Medical Council, health, diagnostic, therapeutic, and pharmaceutical centers, the information technology service companies, as well as people. The contextual elements impacting policy are in three categories, including cultural-social, economic-financial, and political-executive, which have been identified with several impediments to the deployment of electronic health records. The policy process has also faced many challenges in the implementation and evaluation of the policy in a way that after 17 years of the approval of legal decrees due to the electronic health, the implementation has not been based on the assigned tasks and has not been approved by the supervisor.

Conclusion: The electronic health record was considered by focusing on the priority of starting from the family medicine program and the referral chain in the upstream documents, and it was not fully used in Iran's health service provision system still after 17 years. Designing a roadmap, which is confirmed by key stakeholders, clarifying the task of each stakeholder, allocating proper budgets, and paying attention to the infrastructures are the key strategies for a more successful implementation of the electronic health record program.