Electronic Health Reporter

A new report from the U.C. Berkeley Labor Center and Working Partnerships USA shows how technology is likely to impact job quality in healthcare and suggests that technological adoption may accelerate as a result of the COVID-19 pandemic.

The report, titled “Technological Change in Health Care Delivery: Its Drivers and Consequences for Work and Workers,” also finds that the pandemic could provide a wind of opportunity to shift the dominant strategy for technological adoption in health care toward a “work centered” approach.

The current approach is likely to lead to increased surveillance, micro-managing, and worker deskilling, as technologies are used to cut costs. A work-centered approach would instead allow workers to have a say in how new technologies are introduced, to receive training to develop new skills, and ensure their job quality isn’t diminished.

“Technological change in health care is accelerating, putting more strain on workers as providers seek to cut costs and increase efficiency,” said Adam Seth Litwin, the report’s author and an associate professor of industrial and labor relations at Cornell University. “If business continues as normal, we could see workers stripped of rewarding tasks, alienating them from their work and suppressing job quality. But that path isn’t inevitable. If workers are brought into the fold, technological changes can increase the quality of care workers are able to provide, while driving improvements in their pay and job quality.”

Healthcare is one of the largest sectors in the country, with annual health care spending equal to $3.5 trillion in 2017, or 17.9% of GDP. It’s also the fastest growing sector for jobs, with 13% of all private sector workers and 16 percent of the union workforce. Women and people of color are over-represented in many healthcare occupations.

“We know that our need for healthcare workers is growing in the U.S., and the COVID-19 pandemic has underscored just how essential these workers are,” said Annette Bernhardt, director of the Low-Wage Work Program at the U.C. Berkeley Labor Center. “This report shows that the biggest threat that technology poses to health care workers in the near future is not job loss due to automation, but instead job quality loss in the form of reduced wages, and increased micromanaging through surveillance.”

The report identifies three technologies that are likely to see wider-scale adoption in the near future: digital communication, autonomous service robots, and machine learning. Technologies like telehealth, increasingly popular before the pandemic, are facing increased experimentation and will likely be rolled out widely in the coming years. Electronic visit verification threatens micro-surveillance for home healthcare aides. Laundry robots may leave orderlies with fewer, more mundane tasks.

The report suggests, however, that the specific technologies that are adopted and the ways in which they are implemented are not predetermined.

“This report makes clear that policymakers and health care leaders have a choice: they can start by asking ‘what can technology do?’ and relegate humans to filling in the gaps, or they can start by asking ‘what are people good at?’ and use technology to support those people,” said Derecka Mehrens, executive director of Working Partnerships USA. “COVID-19 is showing how brave and dedicated healthcare workers are — we want them providing the care and human connection you’ll never get from a robot.”

The report is part of a broader multi-industry research project led by the UC Berkeley Labor Center and Working Partnerships USA, which examines the impact of new technologies on work. The project is supported by the Ford Foundation, the W.K. Kellogg Foundation, and the Open Society Foundations. This report received additional support from SEIU California State Council, and the Cornell University ILR School.