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Bargaining Health Information Technology

"Once a new technology rolls over you, if you're not part of the steamroller, you're part of the road."  —Stewart Brand

Bargaining HIT New technology radically changes things at your workplace. Current jobs may disappear, new jobs may be created and there may be significant changes in work flow and work processes. You're not just switching from a pen to a keyboard to order meds or do charting; the changes are much more far-reaching and will continue to unfold for many years.

You would think that the knowledge and experience of the people now doing the work would be used in the design and construction of the new systems but that's rarely the case. As a result, money is wasted and unnecessary stress created as workers struggle to adapt to systems that are badly designed and poorly coordinated.

If systems are to work well and accomplish the goals for which they were intended, frontline workers and their unions must be involved from the very beginning in the selection and design process—which may be years before the system is actually implemented.

In a perfect world you would be able to negotiate language that requires employers to notify you as soon as they're even thinking about technological change. For example: “The employer agrees to notify the union in a timely fashion when it is considering the introduction of new technology. Technology will be defined as any changes in tools or equipment that materially change work processes, job descriptions or professional practice.”

This would give the union a chance to advocate for a strong worker voice in the design and implementation decisions and also begin preparation for bargaining over the effects of the new technology.

Getting a Jump on Workplace Change

Don't wait till your contract expires to approach management about negotiating over technological change—the National Labor Relations Act and most public sector bargaining laws give unions the right to bargain over mid-contract changes in wages, hours and conditions of employment. Although employers are not obligated to bargain over the decision to introduce new technology, they are required to bargain over the effects of the new technology. As soon as the union learns that new technology may be introduced, a request for information and a request to bargain should be submitted to management.

  • Download this useful guide from the University of Massachusetts' Labor Extension Program which includes a comprehensive model information request.

Contract Language

Among the questions unions might want to think about when new technology is introduced:

  • Will new jobs be created? If so, should they be in the bargaining unit?
  • Will positions be eliminated? Will those workers be given the opportunity to apply for other jobs?
  • Will current jobs require new skills or additional responsibilities?
  • Will training take into account individual differences in computer skills?
  • Does the new technology include GPS or other monitoring capability? How will that information be used?

When new technology was introduced in the Kaiser Permanente system, under the innovative National Labor-Management Partnership agreement, all the unions were involved in design, training and implementation decisions. This agreement covering issues related to H.I.T. implementation is perhaps one of the most comprehensive now available.

There are other examples of model language on technological change such as this version, which was developed by the Labor Extension Program at the University of Massachusetts.

Technology can lead to advances in patient safety and improvements in professional practice and health outcomes, but only if it’s done right—with the active, meaningful involvement of the frontline workers who will be using it.