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We use Kremser and Blagoev’s [1] role-routine ecology to theorize about the effects of concurrency in complex service organizations, such as outpatient medical clinics. In a typical clinic, teams of specialized individuals serve multiple clients at the same time. There can be concurrency within a patient visit (a technician may be preparing for a procedure while the doctor talks to the patient) and concurrency between patient visits (multiple patients being treated in the clinic). Using data from electronic health records, we estimate the effects of concurrency within and between patient visits on the duration of patient visits in a set of dermatology clinics. As expected, we find that concurrency within patient visits is associated with reduced duration, while concurrency between visits is associated with increased duration. We discuss the implication of these findings for process mining and discovery of process models in organizations where process instances are not independent. 

Using data from the audit trail of an electronic medical record system, we examine the effects of a disruption on the clinical documentation process. We use process mining to construct a network that describes the process and then we use a latent factor selection model to analyze changes to that network. Rather than attempting to discover a particular process model, our goal is to identify theory-based factors that explain change and stability in the overall pattern of actions. We conduct the analysis at two levels of granularity and we compare time periods with and without disruption. The paper contributes to current research on routine dynamics as network dy-namics by demonstrating the use of network science to predict the structure of an organizational routine.