Study design and data collection
This study was a cross-sectional retrospective multicentric study
conducted in the outpatient clinics of 200 Jordanian healthcare
facilities over three years (2017, 2018, and 2019). These facilities
were included from the 12 governorates in Jordan and divided as follow;
Northern Region (Irbid, Ajloun, Jerash, Mafraq), Southern Region (Karak,
Tafilah, Ma’an, Aqaba), Capital Region (West Amman, East Amman) and
Central Region (Balqa, Zarqa, Madaba). Data were collected using
“Hakeem©” database, which is the electronic
prescribing system (EPS) launched by Electronic Health Solutions (EHS)
in 2009, and since then it was used by the ministry of health in Jordan.
The types of electronic medical information we had access to, included,
but were not limited to, the following: comprehensive medical and
surgical history, physical examinations, procedural and surgical
reports, current medications’ names, frequency and dosage, allergies as
well as in-patient and out-patient clinic visit notes. However,
Hakeem© did not include Clinical Decision Support
System (CDSS). The flow of the study approach and design was illustrated
in Figure 1 .