Kaiser nurses say AI call monitoring is eroding patient care

Advice and triage nurses at Kaiser Permanente say the monitoring systems that track their calls are eroding the care they can give patients. Seven current and former nurses told CalMatters that staff who spend more than 15 minutes on a call with a patient routinely face criticism from managers or get called into performance evaluation meetings.

Fifteen minutes per patient

The limit collides with the calls that take longest: patients with several symptoms or chronic illness, new parents seeking reassurance, people who need extended health education, and those processing life-altering news. Calls involving an interpreter often run 30 minutes or more.

Raquel Alvarez Sanchez, an advice nurse in Vallejo since 2010, recalls a call last year with a suicidal patient that ran more than an hour while she waited for police to arrive; she knew it would throw off her average handle time for weeks. As a union steward she has sat in meetings where colleagues had done everything right — except staying on the line past 15 minutes. She fears the pressure pushes nurses to quit or retire early.

Another nurse, anonymous for fear of retaliation, described a call with an elderly woman who had just received a terminal cancer diagnosis. She first thought the patient was suicidal, then understood she was in shock and needed somebody to talk to. She wanted to stay on the line but stopped herself because of her monthly score.

An AI that graded empathy

In the summer of 2024 Kaiser began testing a tool that tried to assess empathy and tone in the voices of nurses and patients, nurses told CalMatters. They answered with a petition demanding patient privacy, more transparency and the right to use their professional judgement, under a slogan from earlier protests: “Trust nurses, not AI.” The tests ended that November, but union representatives were told the program may return.

Kaiser's answer

Kaiser Permanente says its evaluations improve patient outcomes and that it “does not use Average Handle Time to assess agent performance or enforce call time metrics.” Spokesperson Vincent Staupe said the company uses AI responsibly, with human oversight, but does not share details of internal technology systems. How much the monitoring affects patients is unclear: nurses lose contact once they hang up, and a 2024 public-records request found no patient complaints about call times.

The California Nurses Association opened contract talks with Kaiser this month for 25,000 nurses, about 1,000 of them in call centers, with AI a likely issue. Nurses struck for a day over AI in March and picketed last fall; lawmakers are also weighing bills on workplace AI.