At a recent HIMSS11 session on accountable care organizations packed with provider I.T. execs, the speaker asked how many were planning to be part of an ACO. Nearly all raised their hands. If the health reform law survives its legal challenges, they'll soon have the opportunity. Medicaid and Medicare demonstration programs authorized in the law start in 2012 and several private insurers are getting ready to jump in. That said, a survey of the existing healthcare information technology landscape suggests many providers remain years away from having the capabilities to operate as ACOs. The HITECH Act of 2009 was designed to position the healthcare industry to have the information technology infrastructure necessary to support health reform. Nowhere is this clearer than in the I.T. capabilities needed to support ACOs, which seek to tightly coordinate patient care across the continuum of care to improve quality and population health while reducing the unsustainable annual increases in costs.