Objective: to analyze the difficulties in the implementation of telemedicine policy in China and put forward Suggestions for improving telemedicine policy. Methods: Smith model was used as the analysis framework, and four factors including idealized policy, target group, executing agency and environment were analyzed. Results: the implementation of telemedicine policy was in trouble due to the deviation of the policy and regulations, the inconsistency of industry norms and technical standards, the lack of coordination of the implementing agencies and the low acceptability of target groups. Conclusion: the above four factors interact with each other, the government, medical institutions at all levels and relevant departments should take active coordination measures to improve the telemedicine policy and promote the long-term implementation and sustainable development of telemedicine.