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 .