Switching from Cornerstone to a cloud PIMS
Cornerstone is the best-documented server system in the profession, which makes this an unusually honest page: IDEXX's own hardware guides, install guides and help hub describe exactly what you are maintaining. Here is what they say, what a managed move looks like day by day, and what changes on the first morning without the server.
Facts checked on the vendors' own pages, September 3, 2026 · written by the Bittsi team · sources at the end
- Your IDEXX analyzers, reference lab and Web PACS all flow into the record today, and one vendor for software and diagnostics suits you.
- Your server is new, your IT partner is good, and the upgrade cycle is somebody else's job.
- You use a module or integration that no cloud system has offered to rebuild for you.
- You want the server, the Sybase database, the nightly backup and the upgrade weekends gone, and the whole clinic in one browser system: records, hospital floor, anesthesia, dental, inventory, payments, messaging and the pet-owner app.
- You want the migration done for you and verified row by row, live in 14 days, with staff trained by role.
- You want the price on a page, month to month, and your data exported free whenever you ask.
One system. Nothing to integrate.
Everything below is built into Bittsi and priced on one page. Enter it once and it is everywhere it needs to be: the charge posts and inventory moves the moment a treatment is logged. The only integrations are the ones only a lab or a card network can provide: IDEXX, Antech and Bittsi Pay.
Records and charting
Structured SOAP with templates and dictation; vitals and weight trends; vaccines and certificates; prescriptions, refills and labels; consent forms; the invoice drafts itself from the note.
Also: How the visit flows →Hospital floor
A status board with TV mode and shift handoff; live treatment sheets with due times, owners, protocols and fluid alerts; Crash Card dosing by weight with a CPR recorder.
Anesthesia and dental
Vitals charted every five minutes from the monitor with the drug timeline beside them; Triadan dental charts that bill the procedures when completed.
Also: Dental chart →Inventory and purchasing
Batch-level tracking with automatic FIFO, recall trace in about 30 seconds, purchase orders grouped by supplier, cycle counts and COGS per line.
Money
Estimates that convert in one click, Bittsi Pay inside the invoice, next-business-day funding reconciled to invoices, QuickBooks and Xero export.
Clients
Two-way SMS, MMS and email in one thread per patient, reminder cadences that stop on confirmation, and the clinic-branded Companion app.
Also: Companion app →Reporting
Financial, appointment and inventory dashboards that refresh as charges post; shareable links, scheduled PDFs and exports.
AI in the record
Scribe writes the note and the draft invoice from the conversation; Sage briefs every appointment, flags interactions and lab trends, and reconciles close-out.
Also: Sage →What Cornerstone's own documents say
Not our opinion of the product. What its owner publishes, with the source next to each point.
Who owns it
IDEXX Laboratories, the diagnostics company, which lists Cornerstone as "highly versatile server-based software" alongside its cloud products ezyVet and IDEXX Neo. That is a roadmap question worth asking directly: where does the on-premises product sit in a cloud line-up?[1]
What you are maintaining
A Windows Server 2012 to 2022 machine with 16 GB of memory plus 1 GB per thin client, a wired gigabit network, workstations on Windows 10 or 11 Professional, and, on a peer-to-peer network, no more than nine thick-client workstations. Home editions of Windows are not supported, and an unsupported operating system is, in IDEXX's words, not PCI compliant.[2]
Backups and upgrades
The database is a pair of files, cstone.db and cstone.log, and IDEXX recommends backing the folders up daily through an IDEXX backup and/or a local backup. The 9.5 upgrade is a 2.9 GB install plus a database copy, requires 8.5 or later, and warns that laptops on Mobile Computing must be synced first or data may be lost.[3][4]
Why clinics move
The reasons we hear are the same every time: the server, the upgrade weekends, remote access, and the modern gaps: no documentation AI listed for Cornerstone, reporting sold as a separate module, no built-in payments in the way a cloud system means it, no pet-owner app. None of that is a criticism of a system designed in a different decade; it is a description of what a clinic needs now.[5]
Side by side, from the published record
Every Cornerstone cell carries a source number. “Not published” means the vendor does not say on the pages we checked; ask them, and get it in writing.
| Topic | Bittsi | Cornerstone |
|---|---|---|
| Hosting and access | ||
| Where it runs | Cloud-native, built for the browser from the first line of code; any device, including phones; no server, no install, no nightly batch | "Highly versatile server-based software" on a Windows Server in the practice; a Cornerstone Cloud hosted option has its own hardware guide but is not on the current products page[1][2][6] |
| Backups and updates | Handled; nothing to schedule or restore locally | Daily backups of the database folders are your job, "through an IDEXX backup and/or local backup"; version upgrades are installed on your server and must stay within the last three releases[3][2] |
| Workstations | Any current browser on any device, including phones | Windows 10 or 11 Professional or Enterprise; "Home versions are not recommended or supported"; version 9.5 is the last to support 32-bit workstations[2] |
| Price and contract | ||
| Published price | Published, from $249 a month: Foundation $249 with one veterinarian included and $99 per additional veterinarian; Standard $379, or $249 with Bittsi Pay as the primary processor, $129 per additional veterinarian. Unlimited staff users on both. The pricing calculator is the bill, not an estimate | Not published; quote-based[1] |
| Term | Month to month; annual billing saves 10% and can be cancelled at renewal | Not published |
| Setup and migration fees | No setup fee. One fixed migration quote before you sign, included with annual billing; a sandbox loaded with your own records before you commit | Not published |
| Reporting | Financial, appointment and inventory dashboards that refresh as charges post; read-only share links, scheduled PDFs and exports; included in Standard with no separate BI subscription | Practice Explorer, the reporting module, "needs to be purchased separately"[5] |
| Your data | ||
| Getting it out | Your data is yours, always: exported free, in standard formats, whenever you ask; no hostage clause, written into the agreement | Your data lives in cstone.db on your own server. IDEXX does not publicly document a general export utility; the documented export is the ASAP 4.1 controlled-substance report[3][7] |
| What moves to Bittsi | A named migration lead, one person from signature to go-live: clients, patients, visit history, prescriptions, reminders and balances moved, verified row by row against the old system, and you get the report | Clients, patients, visit history, prescriptions, reminders and balances are read from the Cornerstone database and mapped field by field |
| Support and integrations | ||
| Support | One named lead from signature through go-live, then a real person who replies, usually within one business day; engineers answer when a question needs one; demos are hosted by a working DVM | Monday to Friday 6:30 a.m. to 8:00 p.m. Central, Saturday 7:00 a.m. to 4:00 p.m.; phone, email and chat; self-paced course in the IDEXX Learning Center[8] |
| Laboratory and imaging | IDEXX Laboratories, IDEXX Imaging and Antech Diagnostics built in, both directions: order from the record, results and images land on the visit and post their charges to the invoice; one-click activation from the admin panel. Your lab contract stays yours | IDEXX in-house analyzers, reference lab and Web PACS, first party[9] |
| What changes on day one | ||
| Documentation | Sage reads the whole chart: an overnight brief for every appointment, lab trends across panels, medication safety checks, close-out reconciliation of what was documented against what was billed, answers with citations. Scribe writes the SOAP note and the draft invoice from the exam-room conversation. Nothing is sent, billed, prescribed or signed without a clinician | Typed notes; no AI documentation feature is listed on the Cornerstone product pages[1] |
| Payments | Bittsi Pay inside the invoice: tap, dip, swipe, Apple Pay and Google Pay on the terminal; interchange-plus with the network cost and our margin on separate statement lines; next-business-day funding reconciled to invoices; refunds in-line; QuickBooks and Xero export; PCI-DSS Level 1 processor | Through a processor integration and a separate terminal |
| Clients | Built in: two-way SMS, MMS and branded email in one thread per patient; reminder cadences at 30, 7 and 1 days and day-of that stop when someone confirms; post-visit summaries and post-op check-ins drafted from the chart; mass campaigns; and the clinic-branded Companion app for pet owners | Reminders through partner integrations; no first-party pet-owner app[9] |
| Dental and anesthesia | Treatment sheets, anesthesia sheets and Triadan dental charting built in and included in Standard: completing a dental chart bills the procedures and sets the next dental reminder | Paper or add-on |
Bittsi prices from bittsi.com/pricing. Bold text marks the stronger side of a row where there is one.
What Cornerstone does well
- The most thorough public technical documentation of any practice system: hardware and operating-system guidelines, install guides and a public help hub that says plainly what the software needs.
- First-party IDEXX diagnostics and Web PACS in the record, which no third party can match on IDEXX equipment.
- A large integration catalogue: CareCredit, PetDesk, Vetstoria, Weave, Vello, Trupanion, Vetsource, Chewy PracticeHub, MWI, AKC Reunite, VetSnap, Greenline and Instinct.
- Published support hours including Saturday, a phone line, chat and a self-paced course in the IDEXX Learning Center.
- In-family cloud paths, since IDEXX also sells ezyVet and IDEXX Neo, if you would rather stay with one vendor.
What a switch actually looks like
The same plan for every clinic that moves to Bittsi, with a date and an owner on each step. It is written into the Switch Guarantee.
- 01Before you sign: one fixed quote and a sandboxWe size the migration from your current system and load a sandbox with your own records. You click around your real patients, not a demo clinic.
- 02Days 1 to 3: exportYour data comes out of the old system while it keeps running. Nothing changes for the front desk.
- 03Days 3 to 8: mapping and importClients, patients, visit history, prescriptions, reminders and balances, mapped field by field. Anything that cannot be mapped cleanly is archived read-only and labelled.
- 04Days 8 to 10: verificationEvery record checked against the source, row by row. You get the report.
- 05Days 10 to 13: training by roleShort sessions for the front desk, technicians and doctors on the parts they touch, not an all-day shutdown.
- 06Day 14: go-liveOn a lighter day, with your launch lead on call. The old system stays readable for reference until you retire it.
Questions clinics ask about Cornerstone and Bittsi
Can all my Cornerstone history move?
Clients, patients, full visit history, prescriptions, reminders and balances move and are verified row by row against the source. Anything Cornerstone cannot export cleanly is archived read-only in Bittsi, clearly labelled, so nothing is lost even when it cannot be mapped.
How long does it take?
About 14 days from kickoff to go-live for a typical clinic: export and mapping in the first week, verification and role-based training in the second, then a supported go-live on a lighter day.
We run IDEXX analyzers. Do we lose the integration?
No. Bittsi integrates IDEXX and Antech, so in-house and reference results still land in the record. What changes is that your software is no longer tied to the diagnostics company, and your lab choice no longer changes your software price.
Do we keep seeing patients during the switch?
Yes. Cornerstone stays available for reference until cutover, training runs in short role-based sessions, and the go-live is scheduled around your calendar.
What does the migration cost?
One fixed quote before you sign, based on your database size. It is included with annual billing and always included for founding clinics. There is no hourly billing.
What happens to the server?
It becomes a backup you keep for as long as your state's record-retention rule requires, and then a paperweight. Bittsi holds the live record and exports it free whenever you ask.
Sources
Every Cornerstone statement above points to one of these. If a vendor page changes, tell us and we will change the row: info@bittsi.com.
- [1]IDEXX veterinary software products, IDEXX, 2026.
- [2]Cornerstone hardware and operating system guidelines, IDEXX, 2024.
- [3]Cornerstone file structure, Cornerstone Help Hub (IDEXX), 2026.
- [4]Cornerstone 9.5 install guide, IDEXX, 2024.
- [5]Practice Explorer overview, Cornerstone Help Hub (IDEXX), 2026.
- [6]Cornerstone on-premises and cloud hardware guidelines, IDEXX, 2024.
- [7]Cornerstone ASAP 4.1 format guide, IDEXX, 2024.
- [8]Cornerstone current customers and support, IDEXX, 2026.
- [9]Cornerstone integrations, IDEXX, 2026.
Cornerstone and the other product names on this page are trademarks of their owners, used only to identify their products. Bittsi is not affiliated with or endorsed by them. Vendor facts were read on the vendors' own pages on September 3, 2026 and can change; if you are the vendor and something is out of date, email info@bittsi.com and we will check it and correct the page within two business days.
See your own data in Bittsi before you decide.
One fixed migration quote, a sandbox loaded with your records, and a 30-minute walk through your real patients. No slides.