Starting an accountable care organization, or ACO, doesn't take full-blown electronic health records, nor does it require a lot of initial capital, according to some experts. 

Changing physician behavior to lower costs and improve care – as accountable care organizations strive to do – doesn't need much more than a disease registry, according to Paul Katz, CEO of Intelligent Healthcare, LLC in Santa Monica, Calif.

Katz was among a panel of experts who spoke at the ACO operational tools and strategies session of the National Accountable Care Organization Summit, held June 7-9 in Washington, DC.

"The devil is in the data," Katz said. "You've  got to get the data right from day one." 

For an effective ACO, data from all the sources providing a patient's care must go to a single warehouse. This can be done with relatively inexpensive servers available today and free software, Katz said. "You don't need to spend a lot of time and money up front."

Katz said evidence-based medicine programs cost around $200 per physician and "they've proven to do a good job over and over again."

For an ACO to work, doctors need to be shown their progress toward improving care on a near real-time basis, the experts said. 

Eric T. Nielson, MD, senior medical advisor of the Camden Group and chief medical officer of the Greater Rochester Independent Practice Association (GRIPA) in Rochester, N.Y., said electronic medical records aren't required to develop clinical care integration (CI), the precursor to ACOs.

"CI really provides a business case for improving quality and addressing costs by allowing negotiations with payers," Nielson said. 

The top three IT requirements for CI and ACOs include a way to ensure the security of data, guidelines for care, and a way of monitoring performance according to those guidelines, Nielson said.

A basic electronic health record is a good start, according to Mike Cracovaner,  chief executive officer of New Pueblo Medicine in Tucson, Ariz. 

"All healthcare is local," he said, noting that the difference between today and efforts in the 1990s to improve care is that electronic health record allows an easier way to monitor care.

Car dealerships can keep track of your car's upcoming maintenance requirements, so "why can't we do that with healthcare?" he asked.