Conflicting Logics in EHR-AI Integration: Human Factors and Sociotechnical Tensions in Clinical Work

Electronic health record (EHR) systems have evolved from static repositories of patient information into dynamic platforms that increasingly influence how clinicians think and deliver care. As artificial intelligence (AI) becomes integrated into documentation workflows, new challenges emerge in maintaining clinicians' interpretive judgment and empathy within technologically mediated environments. This theory-informed synthesis explores how human factors and sociotechnical tensions have historically shaped EHR design, with a particular focus on balancing relational care and standardized documentation. A structured, manual literature review was conducted, drawing from systems theory, organizational learning, and documentation studies (1951-2023). Findings reveal ongoing conflicts between human-centered and compliance-driven logics, demonstrating how EHR interfaces shape the ethical, cognitive, and emotional aspects of clinical work. Reconsidering EHR design through these competing logics highlights the need for intelligent systems that support human judgment and relational care.