Cornerstone review
IDEXX's long-standing server-based system, with the tightest in-house lab integration available and a learning curve to match.
The short version
If your practice runs IDEXX equipment, the integration is the reason to be here. Almost every reported drawback is a cost you accept for it.
Best for: Established practices running IDEXX in-house lab and imaging, with the staff time to train people properly.
Strengths
- Tight integration with IDEXX diagnostics and imaging
- Flexible, with usually a way to accomplish what you need
- Very large installed base, so staff often arrive trained
- Works without an internet connection
Trade-offs
- Reviewers commonly describe it as difficult to learn
- Interface is not considered user-friendly by many
- Hardware support is charged separately
- Software and support are reported as expensive
- Integrating with non-IDEXX software is reported as time-intensive
Cornerstone is IDEXX's server-based practice management system and one of the most widely deployed in US veterinary medicine. Its defining characteristic is how tightly it connects to IDEXX diagnostics and imaging.
The integration is the point
Reviewers who are positive about Cornerstone almost all cite the same thing: how well it connects to the rest of the IDEXX estate. If your practice already runs IDEXX analysers and imaging, that integration is tighter than anything a third party offers, and it shows up many times a day.
What users consistently raise
The most common complaint is the learning curve. Reviewers describe it as difficult to learn, with an interface many do not find user-friendly. Cost comes up frequently: both the software and the support are reported as expensive, and hardware support is charged on top rather than included.
Performance issues are reported too, with the system bogging down the server. And there is one theme worth pulling out because it connects to ownership: reviewers report that integrating with non-IDEXX software is time-intensive. That is the practical consequence of buying software from a company that also sells you diagnostics.
Ownership
Cornerstone is owned by IDEXX, which also sells diagnostics and equipment to practices. If most of your equipment is IDEXX, that alignment works in your favour. If it is not, or if you want to keep supplier decisions independent of your software decision, it is the thing to examine most carefully. More on that in our guide to who owns your practice management system.
Who it suits
Practices committed to the IDEXX ecosystem, with enough staff continuity to absorb the training cost. Practices running mixed equipment, or planning multi-site, will find the trade-offs harder to justify.
What we do not know yet
Aggregate ratings tell you how a broad population feels. They do not tell you how a practice like yours feels. That is what our survey is for, and once we hold enough responses for a given system we publish that breakdown here alongside the public numbers.
Ratings and recurring themes from Capterra's Cornerstone reviews, checked August 2026. Ratings move; tell us if this is out of date.
Systems covered here
- Cornerstone
About the author
Jan PieterseEditor
Jan edits The Best Vet Software, and reviews everything published here before it goes out.