Oakland, Calif.-based Kaiser Permanente has given labor half the seats on a new AI Task Force with direct decision-making authority over technology investments, under a 2025 agreement with the Alliance of Health Care Unions detailed in a report by Cambridge, Mass.-based MIT Sloan School of Management researchers.
The task force includes 10 senior leaders, five from labor and five from Kaiser. The Alliance represents 62,000 nurses, technicians and other healthcare workers. The deal is the first comprehensive agreement by a major U.S. healthcare employer and its unions to give workers input at every stage of AI decision-making, according to the Sept. 28 MIT Sloan article.
The report was written by Arrow Minster, PhD, of San Francisco State University and MIT Sloan professors Thomas Kochan, PhD, and Erin Kelly, PhD. They identified three lessons for health system leaders:
1. Talk before bargaining. About 300 Alliance leaders and 80 Kaiser leaders met at a joint prebargaining conference in February 2025. Employees said they feared for their jobs, and many wanted a say in AI decisions.
2. Pair top-down governance with front-line input. While the task force oversees systemwide initiatives, more than 3,500 unit-based teams will identify where AI can improve workflows or patient experience. Kaiser is also upgrading its internal project tracker so AI pilots are visible across the organization to minimize duplication.
3. Build trust through union reps. Union reps will train peer advisers to help co-workers adopt AI tools, a model drawn from Kaiser’s EHR rollout two decades earlier. Reps also requested inventories of AI tools and documentation of AI use in hiring and performance monitoring.
“The parties engaged in genuine dialogue and learning, gained a deep understanding of each other’s perspectives, and demonstrated mutual respect,” the authors wrote.
The researchers said unions across sectors, including hospitality and entertainment, are increasingly seeking AI agreements with employers.
