As artificial intelligence continues to be embraced across various sectors, organizations are confronted with a crucial dilemma: how can employees effectively engage in decisions about technology? A pivotal report highlights a groundbreaking agreement between Kaiser Permanente and the Alliance of Health Care Unions, which establishes a framework for incorporating employee input into the decision-making processes surrounding AI and other emerging technologies. This report also explores the necessary steps for successful implementation.
The integration of employee perspectives in AI governance is increasingly viewed as vital for responsible technology adoption. The negotiations between Kaiser Permanente and the Alliance of Health Care Unions in 2025 culminated in a significant agreement focused on artificial intelligence and related technologies. This agreement marks a pioneering endeavor by a prominent healthcare employer and its union partners to involve workers in every stage of AI decision-making, from identifying issues to designing solutions, implementing systems, training users, and providing transition support.
A research team led by Thomas A. Kochan, a professor emeritus at MIT Sloan, along with Erin L. Kelly and Arrow Minster, observed more than 150 hours of negotiations guided by mutual interests. The findings from this research detail the achievements of these negotiations, the processes involved, and the steps necessary to fully realize the potential of the agreement in practice.
Key Insights:
**Incorporation of Employee Input**: This agreement represents the first extensive initiative to involve workers in every aspect of AI decision-making within a significant healthcare institution.
**Dual Strategy**: A National Task Force engages with company-wide initiatives while Unit-Based Teams work on frontline innovations and grassroots problem identification.
**Effectiveness of Interest-based Bargaining**: Collaborative approaches to problem-solving proved more effective than traditional positional negotiations in achieving agreement on complex and unconventional topics.
**Core Commitments**: The introductory section of the agreement emphasizes relational care—maintaining the human aspects of healthcare, ensuring meaningful employee involvement throughout the technology lifecycle, and promoting ethical standards that prioritize transparency and bias reduction.
**Collective Action**: A united effort among various occupational groups and unions facilitated groundbreaking results that individual unions could not achieve alone.
**Broader Implications**: Organizations stand to gain from incorporating the expertise of frontline workers in technology decision-making, raising critical questions about how to secure employee input in contexts lacking formal collective bargaining arrangements.
This research was supported by the Worker Empowerment Research Fund, the MIT Sloan Health Systems Initiative, Omidyar Network, and the MIT Institute for Work and Employment Research. The opinions expressed in the report represent the views of the authors alone.
