To ask the Minister of Health, given that his Department has spent almost £2.5 billion on IT systems over the last three years, to outline the steps being taken to ensure those systems are kept up to date and fully utilised.

Mr Nesbitt

Over the past three years, the Department has spent £508 million directly on digital systems infrastructure and support across the HSC. The wider figure of £2·5 billion refers to the whole-life costs of major digital programmes identified by the Audit Office, including Encompass, new pathology systems and regional imaging. Those are large, multi-year investments that modernise essential clinical and corporate systems. Ensuring that the systems remain up to date and fully utilised is central to our digital strategy. We now have a strong regional governance model across all major programmes that provides clear oversight of performance, risk and standards and aligns with clinical and operational priorities. That, in turn, ensures that systems evolve safely and consistently. I believe that the best example is Encompass, on which we have moved from implementation to continuous optimisation. Trusts, my Department and the supplier partner, Epic, work together to manage upgrades, apply security and functionality upgrades, refine workloads and maintain a clear regional road map. Altogether, that ensures that clinicians and staff have the tools that they need and the system continues to support safe and effective care.

Mr Nesbitt

I thank the Member. Data will be and already is king. The ability of Encompass to give us that solid foundation for analysis is absolutely critical. I see the future of Encompass being not just in electronic patient records but in the ability to do population health initiatives based on the trapping and analysis of data. What is the timeline? I believe that I am right in saying that the digital people talked about it taking two years to fully embed. I get the argument that you should not rush into something and that you need to take solid steps and show that phase 1 has been completed and works really well before moving on to phase 2, rather than trying to get to phase 10 immediately. However, I have a sense of frustration. It is not just me who feels like that; there are some in HSC who feel that there is so much potential in Encompass that we have not yet tapped into. To a certain extent, that is frustrating, because we are missing a trick.

Mr Butler

The Minister rightly pointed out how important the harvesting of data is. Can he give any sense of whether the new systems and investments are directly improving patient care?

Mr Nesbitt

Yes. We see clearer, safer and more consistent care. A single digital patient record means that clinicians have the same up-to-date information wherever a patient presents. For example, if you went to Lagan Valley Hospital and the team there decided to send you to the Royal or the Ulster Hospital, they would not give you a big manila folder with a paper-based trail of your condition to take in the ambulance; rather, the intake clinician at the Royal or the Ulster can go on their machine and look through Encompass to see what to expect when you arrive. That is fabulous. More generally, there is an AI system called Boneview that I have seen at Antrim Area Hospital. That looks at fractures. Within two minutes, it will give a solid analysis — better than the human eye can do. It is particularly useful if you have a major break in your arm as well as two minor breaks. Boneview will make sure that the clinician does not simply focus on the major break and will say, "You do realise that there are two other breaks that you will need to look at". Yes, patient delivery and outcomes are getting better.