diff --git a/app/integrations/ehr.py b/app/integrations/ehr.py
index 369ecac..b0f81fe 100644
--- a/app/integrations/ehr.py
+++ b/app/integrations/ehr.py
@@ -53,6 +53,17 @@ class EhrClient(BaseClient):
         self._token_type: str | None = None
         self._token_expires_at: float | None = None
 
+    @staticmethod
+    def _normalize_token_type(token_type: str | None) -> str:
+        # 北森文档示例返回 token_type=bearer（小写），但鉴权头要求 "Bearer <token>"。
+        # 这里统一规范为首字母大写，避免服务端大小写敏感导致 401。
+        raw = str(token_type or "").strip()
+        if not raw:
+            return "Bearer"
+        if raw.lower() == "bearer":
+            return "Bearer"
+        return raw
+
     def authenticate(self) -> str:
         body: dict[str, Any] = {
             "grant_type": self.grant_type,
@@ -67,7 +78,7 @@ class EhrClient(BaseClient):
         )
         data = resp.json() if resp.content else {}
         access_token = str(data.get("access_token", "") or "")
-        token_type = str(data.get("token_type", "") or "Bearer")
+        token_type = self._normalize_token_type(data.get("token_type"))
         expires_in = int(data.get("expires_in", 0) or 0)
         if not access_token:
             raise RuntimeError("EHR authenticate failed (access_token missing)")
@@ -88,7 +99,7 @@ class EhrClient(BaseClient):
 
     def request(self, method: str, path: str, **kwargs: Any) -> httpx.Response:  # type: ignore[override]
         token = self._get_access_token()
-        token_type = self._token_type or "Bearer"
+        token_type = self._normalize_token_type(self._token_type)
 
         headers = dict(kwargs.pop("headers", {}) or {})
         headers["Authorization"] = f"{token_type} {token}"
@@ -106,7 +117,7 @@ class EhrClient(BaseClient):
             self._token_expires_at = None
 
             token2 = self._get_access_token()
-            token_type2 = self._token_type or "Bearer"
+            token_type2 = self._normalize_token_type(self._token_type)
             headers["Authorization"] = f"{token_type2} {token2}"
             return super().request(method, path, headers=headers, **kwargs)