IDEXX Cornerstone has been a dominant force in veterinary practice management for decades. But as cloud technology transforms how businesses operate, many Cornerstone users are asking: Is it time to switch to a cloud-based PIMS?
This guide provides an honest comparison to help you decide whether staying with Cornerstone or moving to cloud makes sense for your practice.
The Bottom Line
Cornerstone is feature-rich but requires significant IT infrastructure, has higher total ownership costs, and lacks modern conveniences like anywhere-access and AI tools. Cloud PIMS platforms offer more flexibility, lower costs, and features designed for 2026 workflows—often at 50-70% less total cost.
Cornerstone: The Strengths
Let's be fair—Cornerstone has earned its reputation for good reasons:
Deep functionality for complex workflows, especially in larger practices.
Seamless connection with IDEXX diagnostic equipment and reference labs.
Decades of development, large user community, extensive documentation.
Works without internet (since it's server-based).
Cornerstone: The Challenges
However, Cornerstone's architecture creates real pain points for many practices:
Server Infrastructure Required
You need dedicated server hardware, regular maintenance, backup systems, and often IT support. Hardware failures can mean clinic downtime.
No True Remote Access
Checking schedules from home or accessing records during emergencies requires VPN setup—complex and often unreliable.
Manual Updates
Updates require scheduling, downtime, and sometimes technical support. Many practices run outdated versions.
Complex & Dated Interface
The interface reflects its age. New staff often need extensive training. Many workflows feel cumbersome compared to modern software.
High Total Cost
When you add license fees, support contracts, hardware, IT costs, and add-ons, total cost often exceeds $6,000-10,000 annually.
Limited Modern Features
No AI tools, no built-in client portal (requires add-on), no visual workflow management, limited automation capabilities.
Cornerstone vs. Cloud PIMS: Feature Comparison
True Cost Comparison: Cornerstone vs. Cloud
The sticker price doesn't tell the full story. Here's what practices actually spend:
Potential Annual Savings: $5,000 - $13,000
That's money you could reinvest in equipment, staff, or your own paycheck.
When Does Switching Make Sense?
✓ You Should Switch If:
- Server maintenance frustrates you
- You want to access records from anywhere
- Your team struggles with the interface
- You're paying for features you don't use
- Your server is aging and needs replacement
- You want modern features like AI tools
- Client portal would benefit your practice
✗ You Might Stay If:
- Internet is unreliable in your area
- You've heavily customized Cornerstone
- IDEXX lab integration is critical and you fear losing it
- Staff strongly resists any change
- You've recently invested in new hardware
Note: Most of these concerns can be addressed. Modern cloud platforms integrate with major labs and have minimal learning curves.
What About Lab Integration?
A common concern: "Cornerstone integrates with IDEXX equipment. Will I lose that?"
The reality: Most modern cloud PIMS platforms support lab integrations, including IDEXX, Zoetis, Antech, and others. While Cornerstone has native IDEXX integration (they're owned by the same company), cloud alternatives can receive results electronically from all major reference labs. In-house analyzers can typically be integrated as well.
Making the Switch: What to Expect
Data Export from Cornerstone
Work with your new vendor to export patient records, client data, and history. This typically takes 1-2 weeks.
Cloud System Setup
Configure your new platform—typically a few hours with cloud software. Add users, set up services, customize templates.
Staff Training
Modern interfaces require less training. Most teams are comfortable within 2-3 days of daily use.
Parallel Run (Optional)
Run both systems briefly to ensure data transferred correctly and workflows are smooth.
Go Live & Retire Cornerstone
Switch fully to cloud, cancel Cornerstone support, and retire/repurpose your server hardware.
See Why Practices Are Switching to VetSyCare
Experience modern veterinary software with AI tools, visual workflows, and unlimited users—without the server headaches or surprise costs.
Free migration help • No credit card required • Cancel anytime
Frequently Asked Questions
Can I export my data from Cornerstone?
Yes. Cornerstone allows data export, and most cloud platforms can import this data. Work with your new vendor's migration team for the smoothest transfer.
Will I lose my historical patient records?
No. Proper migration transfers patient histories, medical records, and client information. Always verify data accuracy before fully transitioning.
How long does the transition typically take?
Most practices complete the transition in 2-4 weeks, including data migration, setup, and training. Cloud software setup itself takes only hours.
What if my internet goes down?
Modern practices rarely have extended internet outages. For peace of mind, a cellular backup hotspot (under $50/month) ensures continuous operation.
My staff is comfortable with Cornerstone. Will they adapt?
Modern software is designed to be intuitive. Most staff prefer it once they experience the cleaner interface and faster workflows. Resistance typically fades within the first week.