Montefiore nurses represented by the New York State Nurses Association (NYSNA) are furious over what they described as the layoff of 12 experienced nurses to be replaced with artificial intelligence software.
Bronx elected officials joined a virtual press conference on July 1 that included NYSNA nurses, Council Member Shirley Aldebol, who chairs the labor committee, along with Assembly Members Jeffrey Dinowitz, Karines Reyes and Amanda Septimo and State Senator Nathalia Fernandez. Assembly Member George Alvarez issued a statement in support of NYSNA, and several other Bronx officials sent staffers to the meeting.
Nurses said they are “outraged” that Montefiore has already laid off 12 nurses in the utilization review department, dealing with patients at all three Bronx campuses, Moses, Einstein and Weiler. These nurses review patient files to ensure that their care is medically necessary and covered by insurance, ensuring that the hospital will be reimbursed, according to the American Nurses Association.
Montefiore did not respond in time for publication.
The layoff news comes just a few months after the end of a bitter 41-day strike that began Jan. 12. On the picket lines, Montefiore nurses accused management of doling out excessive corporate salaries, investing in wealthier suburbs over the Bronx and undermining patient care in an understaffed emergency room.
“I deeply regret to inform you that your position will be eliminated 45 days from the date of this letter. During this time, the Medical Center will work closely with you to determine whether there are suitable positions that in accordance with the collective bargaining agreement. Montefiore recognizes the commitment you have made to its patients and will work hard to make this transition easier for you. The Medical Center is very sorry it must take this action,” said a letter sent to 12 nurses from human resources on May 28.
As the July 12 termination date approaches, the nurses said they are unclear on the hospital’s exact plans but believe their work will be performed by artificial intelligence software — and that they’re horrified by the prospect.
They expressed particular concern about the company Montefiore is allegedly working with, an Arizona-based information tech company Datavant. The Bronx Times reached out to the company but did not hear back in time for publication.
The nurses cited concerns about patient data security, pointing to the company’s recent agreement to pay $900 million to settle a class-action lawsuit for a data breach that allegedly had potential to expose patients’ names, dates of birth, addresses, Social Security numbers, financial account information, health information and more.
Nurses also said they worried that patients’ immigration statuses could be collected and accessed by Immigration and Customs Enforcement (ICE). They said Datavant is connected to the company Palantir, founded by billionaire Peter Thiel, which contracts with the U.S. government to create a data platform to track illegal immigrants and collaborate with ICE, according to reporting by Wired and other outlets.
The Bronx Times was unable to confirm a direct connection between Datavant and Palantir, but concerns about patients’ sensitive information were of top concern for the nurses’ union.
Marilyn Shuler spoke at the press conference and is one of the nurses laid off after 39 years at Montefiore across several departments.
Shuler’s six years working in utilization review showed that nurses play a “vital role” in patient advocacy, as well as ensuring the hospital gets paid.
“It’s unbelievable that a machine can replace the experience and clinical judgment we have,” she said.
Shuler said things began to change in her department soon after the strike. Their workflow changed without explanation, and colleagues informed their union representatives. About a month later, with no response from Montefiore management, her whole unit was notified of the layoffs, according to Shuler.
“How do you eliminate an entire department without some transparency to your employees?” she said.
In the Bronx, Shuler said many patients have complex needs and factors that affect their care and coverage, and determining whether an individual’s care is medically necessary can be a sensitive judgment call.
“The majority of our cases are complex and don’t fit a template,” she said. “When AI becomes the only basis for these decisions, our patients can fall through the cracks.”
Ajita Mathew, who has worked 36 years as a nurse and 20 years at Montefiore, said it was “heartbreaking” to see the department’s work “reduced to a click.”
According to Mathew, management has said Datavant is not actually AI, but has also not explained how the department will function going forward.
“We were told that someone is going to be clicking the needed clinicals from the patient’s chart, which is then sent to the payer,” Mathew said. “It was not clear to us whether this task is to be done by a nurse or a machine.”
Mathew and several others echoed the same concern about cutting nurses who care for Bronx patients.
“The complicated cases are the ones the machine will get wrong.”
Bronx elected officials on cutbacks
During the press conference, Aldebol called on Montefiore to stop the layoffs and engage nurses in conversations about AI. She said she was “deeply concerned” from both a labor and healthcare standpoint.
“Montefiore has to respect the contract that they just negotiated,” Aldebol said. “Without engaging in a meaningful discussion about these plans, they are clearly disrespecting the nurses, disrespecting the union and disrespecting the contract.”
Other elected officials lamented the loss of Bronx union jobs, the alleged lack of conversation around the changes and the breakneck speed of AI implementation in general.
Dinowitz said he has “lost track” of how many times he has supported Montefiore nurses on the picket line, calling it “an endless battle.” But this time, he said he worried that the current layoffs might signify the beginning of a slippery slope.
“If they’re able to get away with this, with these 12 nurses, they’re gonna keep doing it over and over again in every possible area,” he said.
Dinowitz said he is generally not opposed to implementing healthcare technology, “But we have to be very strong in making sure that new technology is not abused and is not used as a tool to cut costs, cut patient care, and make things worse than they are.”
“If this is just the beginning, we gotta nip it in the bud,” Dinowitz said.
Reach Emily Swanson at eswanson@schnepsmedia.com or (646) 717-0015. For more coverage, subscribe to our newsletter and follow us on Twitter, Facebook and Instagram!
