Conceptualizing Collaboration in Electronic Health Record-Mediated Healthcare: A Systematic Review of CSCW studies, 1996–2025

Computer-Supported Cooperative Work (CSCW) has produced over three decades of research on medical records and the collaborative practices surrounding them. With increasing digitalization of healthcare, electronic health record (EHR) systems have become a central focus of this work. Although many CSCW studies examine EHR systems and the documentation practices they support, the field lacks a systematic synthesis of how collaboration in EHR-mediated healthcare has been conceptually framed. As a result, the cumulative analytical contribution of this research remains difficult to assess. To address this gap, we conducted a systematic literature review of CSCW research published between 1996 and 2025. From 82 references identified through database searches, 42 articles met our inclusion criteria and were analyzed in depth. Through an iterative qualitative synthesis, we identified seven conceptual categories structuring CSCW understandings of collaboration in EHR-mediated healthcare: (1) Documentation as coordinative and sense-making practice; (2) Artifacts, affordances, and local adaptation; (3) Coordination, redundancy, and resilience; (4) Infrastructuring and integration; (5) Power, participation, and politics; (6) Accountability, representation, and organizational control; and (7) Privacy, consent, and negotiation. By consolidating this fragmented scholarship, the review clarifies key conceptual contributions and outlines implications for CSCW research and the design and implementation of EHR systems.