Effects of Concurrency in Complex Service Organizations: Evidence from Electronic Health Records.

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.