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Veterinary · head to head

IDEXX Cornerstone vs RxWorks

IDEXX Cornerstone logo

IDEXX Cornerstone

Veterinary

On-premise veterinary practice management software tied to the IDEXX diagnostics ecosystem

From
On request
Rated
-
Full reviewWebsite
R

RxWorks

Veterinary

Server-based practice management with a corporate group heritage in Australia, New Zealand and the United Kingdom

From
On request
Rated
-
Full reviewWebsite

The short version

  • Each has a real cost: IDEXX Cornerstone the system runs on a server in the building, so the practice pays for hardware, backups and an IT provider, costs that never appear in a comparison against browser based competitors.; RxWorks it is a legacy line inside Covetrus, which promotes Pulse as its strategic cloud product, so the practical question is not capability but how long the system will be supported and on what notice.
  • They diverge on capability: IDEXX Cornerstone covers Medical records, RxWorks covers Multi-site group operation.
  • Prices and features above were last checked on 1 September 2026.

Where they differ

Only the attributes on which IDEXX Cornerstone and RxWorks actually diverge.

Attributes where IDEXX Cornerstone and RxWorks differ
AttributeIDEXX CornerstoneRxWorks

Identical on both: starting price (On request), pricing model (quote), free tier (No), platforms (Windows), user rating (Not yet rated), category (Veterinary).

What each one covers

Drawn from each product's published feature list. An absence here means we hold no record of it - not that the product lacks it.

Only in IDEXX Cornerstone

  • Medical records
  • Diagnostics integration
  • Estimates and invoicing
  • Inventory control
  • Boarding and grooming
  • Wellness plans

Only in RxWorks

  • Multi-site group operation
  • Dispensing and stock control
  • Client accounts
  • On-premise database
  • Regional configuration
  • Laboratory integration

What people use each for

The jobs each tool is most often brought in to do.

IDEXX Cornerstone

  • A multi-doctor general practice already running IDEXX in-house analysers that wants results in the record automaticallynot RxWorks
  • A clinic with unreliable internet where an on-site server keeps the practice working during an outagenot RxWorks
  • A practice that boards and grooms as well as treating, and wants those bookings on the same invoicenot RxWorks
  • A group needing consolidated reporting across a small number of owned locationsnot RxWorks

RxWorks

  • A practice joining an Australian, New Zealand or United Kingdom group that already standardises on RxWorksnot IDEXX Cornerstone
  • A group that needs consolidated reporting and centrally controlled price lists across many sitesnot IDEXX Cornerstone
  • A mixed or large animal practice that runs account customers on credit terms rather than payment at the time of servicenot IDEXX Cornerstone
  • A site that cannot rely on its internet connection and needs the clinical record held locallynot IDEXX Cornerstone

Where each one falls short

Documented limitations, not opinions. Every one is a constraint you would hit in normal use.

IDEXX Cornerstone

  • The system runs on a server in the building, so the practice pays for hardware, backups and an IT provider, costs that never appear in a comparison against browser based competitors.
  • It is Windows only with no meaningful mobile access, which rules it out for house call and ambulatory work and leaves staff tied to workstations.
  • The interface is dense and dated, so training a new receptionist or technician takes materially longer than on newer systems.
  • Commercial gravity runs towards IDEXX diagnostics, and a practice that later moves its laboratory work to a competitor loses the automation that justified the software.
  • IDEXX is directing new customers towards its cloud products, so investment in Cornerstone is maintenance oriented and buyers should assume a migration conversation within the life of the purchase.

RxWorks

  • It is a legacy line inside Covetrus, which promotes Pulse as its strategic cloud product, so the practical question is not capability but how long the system will be supported and on what notice.
  • It is a Windows server product, so the group carries hardware, database, patching and backup costs that never appear in the software quotation.
  • Its relevance is regional: outside Australia, New Zealand and the United Kingdom the installed base and the support and consultant network are thin, which matters for a group expanding into new markets.
  • Remote and mobile working is poor compared with cloud systems, which is a growing problem as groups centralise administration and clinicians expect record access away from the practice.
  • The eventual migration off it will be a full data conversion with retraining across every site, and at group scale that project cost should be modelled now rather than treated as a future problem.

Pricing, plan by plan

IDEXX Cornerstone

On request
  • Cornerstone$undefined/year
    • Licence priced by number of workstations and modules
    • Annual support and maintenance charged separately
    • Server hardware and IT support are the responsibility of the practice

RxWorks

On request
  • RxWorks$undefined/year
    • Quoted per site, normally under a group agreement
    • Annual support and maintenance charged separately
    • Server infrastructure is the responsibility of the practice or group

Which should you pick?

Choose IDEXX Cornerstone if

  • You need medical records.
  • You work on Windows.
  • You also want diagnostics integration.
IDEXX Cornerstone review

Choose RxWorks if

  • You need multi-site group operation.
  • You work on Windows.
  • You also want dispensing and stock control.
RxWorks review

Questions people ask

Is IDEXX Cornerstone or RxWorks better?
Neither clearly leads. IDEXX Cornerstone starts at On request and RxWorks at On request, and user ratings are close enough to be indistinguishable. Choose on capability and platform support.
Which is cheaper, IDEXX Cornerstone or RxWorks?
IDEXX Cornerstone starts at On request and RxWorks at On request.
Does IDEXX Cornerstone or RxWorks run on more platforms?
Both run on Windows, so platform support will not decide this one for you.
What is IDEXX Cornerstone best used for?
IDEXX Cornerstone is most often used for a multi-doctor general practice already running idexx in-house analysers that wants results in the record automatically, a clinic with unreliable internet where an on-site server keeps the practice working during an outage, a practice that boards and grooms as well as treating, and wants those bookings on the same invoice, a group needing consolidated reporting across a small number of owned locations. Of those, a multi-doctor general practice already running idexx in-house analysers that wants results in the record automatically and a clinic with unreliable internet where an on-site server keeps the practice working during an outage are not what RxWorks is typically brought in for.
What can IDEXX Cornerstone do that RxWorks cannot?
IDEXX Cornerstone covers Medical records, Diagnostics integration, Estimates and invoicing, Inventory control. RxWorks covers Multi-site group operation, Dispensing and stock control, Client accounts, On-premise database.

Answered from the vendors’ own pages

IDEXX Cornerstone: Is Cornerstone cloud based?

No. It is installed on a server at the practice. IDEXX sells separate browser based products for clinics that want cloud.

RxWorks: Should a new practice adopt RxWorks today?

Generally no, unless you are joining a group that already runs it. A new independent practice should be evaluating cloud systems instead.

IDEXX Cornerstone: Does it work with laboratories other than IDEXX?

Results can be handled, but the automatic requisition and result return that make Cornerstone worth its price are built around IDEXX.

RxWorks: Is it still supported?

Covetrus supports it, but Pulse is the stated strategic product. Ask for the support commitment and the end-of-life notice period as written contract terms.

IDEXX Cornerstone: What is the real total cost?

The licence and annual support are only part of it. Add the server, backup, workstation refreshes and an IT contract before comparing with cloud systems.

RxWorks: Where is it actually used?

Mostly Australia, New Zealand and the United Kingdom, heavily within corporate practice groups. It has very little presence in the United States.

IDEXX Cornerstone: Can it be accessed from home?

Only through remote desktop or similar, set up and secured by the practice IT provider.

RxWorks: What does migration off it involve?

A full clinical and financial data conversion per site plus retraining. At group scale that is a programme of work, not a weekend.

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