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GARUN.PRDT /
August 4, 2026
Union leaders say Oregon Health & Science University managers may be violating labor law by keeping workers out of the loop about the institution’s growing use of artificial intelligence.
The debate at OHSU comes as AI is remaking health care around the globe in ways that are sparking both praise and criticism. While AI is assisting medical care in some ways, critics say it risks hurting providers and patients in other ways..
At Local 328 of the American Federation of State, County and Municipal Employees, union leaders want to ensure OHSU establishes safeguards such as tracking errors by AI as well limitations on surveillance, and the protection of providers’ skills that ensure quality care.
And they say OHSU has not been notifying unions about its use of AI in ways that could affect the wages, hours or working conditions of employees — changes that require formal notification to allow for a 90-day interim bargaining process outside of the regular contract renewal schedule.
“They are required to tell us so that we can negotiate the change,” Bologna told The Lund Report. “Instead, we have had to go looking for it. It’s been like pulling teeth to get them even to tell us what projects there are.”
Local 328 represents over 9,000 workers at OHSU, including therapists, social workers, environmental service workers, and IT staff, as well as other non-clinical positions across its facilities. The union, one of many at OHSU, signed a three-year labor agreement in January.
Bologna said OHSU leaders called the union’s initial request in May to begin bargaining on the issue “premature,” prompting the union to survey members for more information on how AI is used in their workplace. The union also filed a request for information from the university about its AI-driven projects and received hundreds of examples. The union believes some of them will affect working conditions or wages or involve surveillance, according to Bologna, who said the union signed a non-disclosure agreement when receiving the information.
The two sides began initial negotiations in late May involving all five AFSCME bargaining units at the university, but they have been contentious Bologna said OHSU negotiators told them at the outset that they were not interested in changes to the current contract
In a statement to The Lund Report, an OHSU spokesperson said the university is engaged in bargaining a new agreement with the union.
“OHSU has a long history of respectful and productive relationships with its unionized members,” the spokesperson said. “We have met with union representatives to hear their concerns, and are sensitive to them. To that end, we are currently bargaining an agreement regarding future potential AI projects at OHSU.”
In a July blog post for union members, Bologna listed the type of AI projects the union felt met the criteria for bargaining, including its use in insurance appeals, prior authorizations for prescriptions, and generating performance metrics.
“It is a big threat to workers,” Bologna told The Lund Report. “It’s a topical issue for a lot of people right now … Their biggest concerns are fear of layoff or fear of job replacement.”
Bologna also mentioned concern about AI automation in scheduling and other uses that simplify jobs to require fewer skills and consequently lower pay — a phenomenon called “deskilling,” which can hurt providers’ ability to provide quality care.
“We want to make sure that our workers don’t lose skills that they had because those tasks were given to AI,” Bologna said.
“OHSU has built in some safeguards, like using a “human in the loop” model, but we do not feel the AI has the same level of care as our staff. Nor have we been able to participate in the development of those safeguards,” Bologna said.
Another aspect concerning to the union is time workers spend adjusting ror correcting AI errors.“If staff are asked to address erroneous AI outputs, those are new duties assigned to them, which we believe would change their working conditions.”
Bologna said that if necessary, the union is prepared to file an unfair labor practices complaint with the state Employee Relations Board over the failure to notify them of AI projects, through more work has to be done to document projects’ impact on workers.
OHSU employs more than 22,000 people, and operates hospitals and clinics across Oregon and southwest Washington. Publicly owned, OHSU is Oregon’s only academic health center.
The OHSU spokesperson said university president Dr. Shereef Elnahal has made AI a strategic priority to aid workers, not replace them.
“OHSU will strategically deploy AI in a manner that is assistive to our people and to their work, and not in a way that is disruptive or supplants people’s work,” the spokesperson said. “AI can help with rote tasks across many roles and specialties in a way that is helpful to both represented and non-represented members. AI can enhance our members’ experiences in research, education and healthcare, but it cannot and will not replace them.”
In addition to protecting workers from displacement or layoffs, the union wants OHSU to agree to having worker involvement in AI implementations, including multiple seats on the AI governance committee and involvement in the feedback process and error tracking. It also wants OHSU to provide notice to the union before any AI system is put into use, and to put limits on surveillance tools.
“We don’t want to get in the way of science. We don’t want to get in the way of technology and progress,” Bologna said. “But we are trying to just get protective language that says you can’t outsource our work to AI.
Health systems across the country have embraced AI technology to trim costs, offset staffing shortages and even assist in care. OHSU has touted its Center for AI-enabled Learning Health Science as one of the first in the country to apply AI to collect data about patient conditions, treatment and outcomes to find patterns that will ultimately aid in patient care. The university maintains that the information is collected “safely and privately.”
In a 2025 interview with HealthcareITNews, an OHSU executive spoke about AI’s impact at OHSU Hospital in coding, the translation of medical procedures into code for billing purposes. In the interview, Tammy Bickle, director of revenue cycle at OHSU, said AI assistance reduced coder workload by nearly 28% and reduced coding-related denials for payment.
OHSU’s AI initiatives are subject to initial review and approval by its Artificial Intelligence Governance Committee. According to the OHSU spokesperson, the committee’s work focuses on “responsible and transparent use of AI tools at OHSU, in alignment with strategic goals and ethical standards.” If the committee approves an AI project, it is sent to OHSU mission leadership to decide whether or not it’s put into use, the spokesperson said.
Bologna joined the committee as its only union representative in March, but only after months of stonewalling by the university, he said. And then he was left out of the email voting process on final AI decisions He said he was told OHSU was waiting to appoint a permanent union position before letting them vote
The spokesperson for OHSU said the university offered the union a seat on the committee, and the initial confusion over its voting status was a misunderstanding.
“After the union recently made clear that their representative was not an interim member, OHSU gave the representative full access to committee lists and voting mechanisms,” the spokesperson stated.
The union thinks more union seats are called for, to reflect multiple bargaining units composed of different types of workers.
