But health reform itself is on the line.
The debate is over what doctors and hospitals need to do in order to get part of the $19.2 billion in HITECH money that was part of the Obama stimulus. The rules will define what they buy.
On one side we have HIMSS, the health IT industry group, and CCHIT, which HIMSS created to certify systems as meeting standards but now denies it controls. They have called for CCHIT to keep doing what it's doing, this time with government money behind it.
On the other side are a collection of health IT professionals, open source advocates and new vendors who say that CCHIT is locking new technology out of the market. Giving CCHIT control of the stimulus, they argue, would be like putting Microsoft in charge of the Internet.
So far, the government has tried to split the difference. Reformers are pleased that some CCHIT-certified solutions will need upgrades to meet the new standards, and that the standards are a moving target. They say David Blumenthal, the official in charge of the health IT effort, understands their concerns.
There is some evidence the industry is feeling some heat. CCHIT chair Mark Leavitt (above) took out after reformer David Kibbe by name last month, on a blog Kibbe contributes to, claiming he demeaned the integrity of "everyone who has contributed" to CCHIT's work. Other bloggers got out the popcorn.
Open source advocate Fred Trotter writes that CCHIT's problem is it supports "Proprietary, Rigid, Overweight, Bloated, Loaded, Expensive, and Massive (PROBLEM) EHR products," all-in-one solutions that were popular decades ago but have been made obsolete by concepts like open APIs, plug and play, and open source, in which customers build solutions from modules that just snap together.
But it could still be CCHIT that has the last laugh.
Next month the advisory panel supporting Blumenthal will hold hearings on how meaningful use will be certified, and who will decide whether gear is eligible for subsidy.
CCHIT could still be named the certifying agency, as was planned under former HHS Secretary Mike Leavitt (no relation to CCHIT's Mark).
So stay tuned.