It's hard to imagine a successful accountable care organization (ACO) that doesn't rely heavily on IT. ACOs require that clinicians meet a long list of quality measures to prove that they're acting in an accountable way to reduce costs without reducing the quality of medical services. And most of those metrics are best tracked with software. But the very foundation upon which ACOs are built could be shaky, making software tools only so effective. If genuine accountability is your goal, technology gets you only halfway there. Providers need a proven structural model to make an ACO cost effective, and at least one prominent thought leader questions whether the current approach will do the trick.