Int J Med Inform. 2026 Sep 14;222:106724. doi: 10.1016/j.ijmedinf.2026.106724. Online ahead of print.
ABSTRACT
BACKGROUND: Previous studies on physicians' work in Japan relied on self-reported surveys or attendance records, providing limited insights into their hospital activities. This study aimed to visualize the work patterns of physicians at a university hospital and identify factors associated with extended working hours using a system integrating a smartphone application with beacon technology, which was developed in-house.
METHODS: In this prospective observational study, a smartphone application integrated with Bluetooth Low Energy beacons automatically recorded physicians' locations and duration of stay across outpatient areas, wards, operating rooms, examination and procedure rooms, other clinical areas, and self-study areas. Time spent in self-study areas and time spent in all other locations were defined as location-based self-development time and location-based working time, respectively. These measures were compared with the corresponding attendance records. Factors associated with weekly working time and weekly total working time, both recorded by the attendance management system, were identified using multivariable regression analysis, and work patterns were classified using cluster analysis.
RESULTS: A total of 2,735,360 valid beacon records were included in the analysis. The mean weekly total location-based working time derived from beacon measurements was 14.5 ± 14.8 h/week, including a mean weekly location-based working time of 7.1 ± 8.6 h/week. The corresponding mean weekly total working time recorded by the attendance management system was 29.0 ± 17.4 h/week, including a mean weekly working time of 13.9 ± 9.7 h/week. Across both measurement systems, physicians aged ≥ 50 years had the longest self-development time and the shortest working time. Cardiovascular surgery had the longest attendance-recorded working hours, whereas rheumatology had the longest location-based working time, followed by cardiovascular surgery. Rehabilitation medicine had the longest attendance-recorded and location-based self-development time. Older age, affiliation with surgical or other departments, and longer beacon-derived ward time were independently associated with longer attendance-recorded weekly total working time; sex and academic position showed no significant associations. Cluster analysis revealed eight distinct work patterns.
CONCLUSIONS: The beacon-based system objectively captured physicians' location-based on-site presence patterns. The substantial variation in work patterns and the discrepancy between location-based on-site time and administratively recorded working time highlighted the complexity of physicians' workloads. Thus, department-specific strategies are necessary to promote effective work-style reform and improve physicians' well-being.
PMID:42762632 | DOI:10.1016/j.ijmedinf.2026.106724