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Published on:

28th May 2026

399 - ARE PIMS Still the Center of Your Practice?

Jon Ayers, former Chair and CEO of IDEXX, joins Dr. Andy Roark for a conversation that might completely change the way you think about veterinary PIMS, AI scribes, and the future of practice workflows. If you’ve ever felt frustrated by clunky software, disconnected systems, or the endless admin burden slowing your team down, this episode digs into why AI could dramatically reshape how veterinary teams interact with medical records, client communication, and even daily decision-making. From open APIs to AI-powered workflows, Jon breaks down what practice owners should be asking about their software now, and why the clinics that adapt early may have a major advantage in the years ahead. Gang, let’s get into this episode.

LINKS

Jon Ayers on LinkedIn: https://www.linkedin.com/in/jon-ayers-a44b3/

https://catalystcouncil.org/

https://www.vetsoftwarehub.com/

Mentioned in this episode:

Office Hours w/ Dr. Andy Roark

Inside the Uncharted Veterinary Community, Dr. Andy Roark hosts Office Hours where veterinary leaders can bring real-world challenges and get practical guidance from someone who understands the realities of practice life. These sessions give veterinarians, practice managers, and team leaders a chance to ask questions, workshop difficult situations, and gain perspective on issues like team dynamics, communication, burnout, and clinic operations. Instead of navigating leadership challenges alone, members get direct access to Andy’s insight along with the support of a community of veterinary professionals working through many of the same challenges.

Register for Office Hours here!

Uncharted Practice Manager's Summit

Last Chance to Register is June 1st 2026 - Tell your managers! Registration is only $199 and they can save 20% with code MANAGER

Register for the Practice Manager's Summit here!

Sign up for the Early Career Newsletter here!

Learn more about Simparica Trio here!

Transcript
Speaker:

dr--andy-roark-_1_02-27-2026_131235:

Welcome everybody to the Kone

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:

of Shame Veterinary podcast.

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:

I am your host, Dr.

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And Dewar.

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Guys, I got a great one today.

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This is a mind bender.

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and I am here with John Ayers,

the former chair and CEO of

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Idexx, and he is writing a lot.

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And thinking a lot about AI and how

it's gonna interact with our PIM system.

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And I know that probably doesn't sound

like the sexiest topic right off the top.

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I appreciate you clicking on the podcast

and listening when you saw PIMS and AI and

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you're here you are and I appreciate it.

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And lemme tell you, this is

totally worth your time and effort.

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Guys, the PIM system is the heart

and soul of a lot of our ve.

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It's not the soul.

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It's the heart of a lot

of our vet, practices.

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It is, the, it's where a

lot of our work gets done.

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The way that we interact with

it makes up a lot of our day.

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it either helps or hinders our

efficiency and getting things

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done, like it really plays a huge

role in getting medicine done and.

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I am fascinated with how AI is going

to fundamentally change the way

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we interact with the PIM system.

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How is this AI thing gonna

actually make our lives better?

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That's what we get into

with John Airs today.

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It's really, really interesting.

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He's got a really neat vision of

where this all goes, and I think

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he's, Appropriately pragmatic.

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he, he's very much like

everything is moving fast.

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It's hard to tell, but these are

the things that are important

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and this is where it's going.

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And I just, I think, I dunno, I think

he's got excellent clarity, insight.

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He definitely affected my thinking on

I sort this topic and what the short

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term future in vet medicine looks like.

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And I really tried to bring this down

Very much to the practice level, to try

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to get in my head around what's it gonna

be like when I'm seeing appointments?

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what does this mean?

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Anyway, this is a really

good episode, guys.

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I hope that you're going to enjoy it.

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Let's get into it.

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Kelsey Beth Carpenter: This is your show.

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We're glad you're here.

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We want to help you in

your veterinary career.

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Welcome to the Cone of Shame with Dr.

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Andy Roark.

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dr--andy-roark-_1_02-27-2026_131235:

Welcome to the podcast, John Ayers.

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Thank you for being here, my friend.

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squadcaster-eid5_1_02-27-2026_131158:

Thank you, Andy.

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dr--andy-roark-_1_02-27-2026_131235:

It is a real, it's a real

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honor to have you here.

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For those who don't know you, you are

the former chair and CEO at idexx.

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you are also, currently a board

member at Catalyst Council, which

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is a nonprofit organization focused

on the wellness and benefits of.

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Katz, you are fairly prolific writer.

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I like to read, your stuff a lot.

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I follow you on LinkedIn.

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You've had a number of articles and

posts that have been coming out.

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there's a million things

I could talk to you about.

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I just, I think your work around, around

access to care one is interesting.

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access to care specifically for

cats I think is interesting, but

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I wanna get in today and talk to

you a little bit about some of the

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stuff you've been writing around ai.

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Inside of veterinary practice

and so you have an article.

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The article is, titled, so

it's a whopper of a title.

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It's Companion Animal veterinary software.

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Pims in the age of ai, colon

weather, the storm or withered.

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I really like the subtext, what becomes

of the veterinary PIMS in the world of ai.

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And that's what I was really interested.

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So I'm looking at your article and John, I

think that you are thinking about this at

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a level that I haven't seen anybody else

really get in the weeds and think about.

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And can you go ahead and just,

let's just start at a high level.

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I'm gonna say most of the people who

listen to this podcast are very familiar

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with the veterinary PIM system, right?

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It's the practice management, system.

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it's our information

systems and our practices.

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This is the nerve center

for most vet practices.

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John, where do you see this, the

PIM system in say, five to 10 years?

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have some pretty, pretty big ideas

about how that's gonna be different.

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Can you paint me a picture

of of what you're expecting?

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squadcaster-eid5_1_02-27-2026_131158:

Andy, I, it's hard for me to even

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figure out the next year or two because

things are moving so fast in ai.

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for those that are not familiar,

there's something called the SaaS

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apocalypse, which is software

as a service is being completely

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upended, in the general markets.

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companies that are big SaaS

companies like Salesforce and

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HubSpot's down 75% from their peak.

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everybody is wondering

what is the future of SaaS?

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dr--andy-roark-_1_02-27-2026_131235: Yeah.

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squadcaster-eid5_1_02-27-2026_131158:

so now we, we bring ourselves

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to veterinary medicine.

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Now, of course, not all PIMS or

PIMS are software as a service.

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Many of them are still working

quite well as, server-based or

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what's called on-premise.

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and I think close to half of

the industry still on premise.

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But if you look at the basic.

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Role a pims, and this is,

really important to understand.

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It's two things.

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First of all, it's your data.

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dr--andy-roark-_1_02-27-2026_131235: Yep.

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squadcaster-eid5_1_02-27-2026_131158:

It's your medical records, it's

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your schedule, it's your, inventory.

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Your client communications, your

service, and product charges.

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it's, your cash register.

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it's your boarding and grooming it.

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There's a lot in there which are

basically made up of databases.

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And databases are important because

you can't schedule two appointments

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in the same appointment slot.

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Okay?

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So the PIMS has to keep

track of all of this.

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Particularly the pet owner data.

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But all of these datas, this is what's

therefore called in industry parlance, or

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technology parlance, the system of record.

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So it is the single canonical, place

where your data is stored, and you

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know the data, the pims make sure

there's not two entries for the same

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pad, or two appointments and the same

appointment slot and that kind of thing.

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The second role that your,

PIs play, it's its workflow.

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It helps you update those databases with

workflow, putting charges in from the

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appointment or scheduling appointments.

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all of those things are what

we'd call applications that

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help the practice their data.

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Okay, so now in the world, this

is important to understand.

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a database and it's a set of applications.

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Now, most pims were

never actually designed.

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They were designed as one big,

everything merged together.

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Okay?

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But now in the age of ai, there are all

these different applications veterinarians

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are adopting want me and need access.

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That systems of record.

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So you may have adopted the simplest ones.

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You may have adopted a scribe and you

want the scribe to be able to read

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from the medical record and to be

able to, with approval and the right,

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oversight, be able to write back, to

the medical record or charges that were

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talked about during the appointment.

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So these are called

read and write accesses,

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dr--andy-roark-_1_02-27-2026_131235: Okay.

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squadcaster-eid5_1_02-27-2026_131158:

those read and write accesses are.

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facilitated by what's called an API

or application program interface.

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And I promise I'll give no

more technical jargon, but the

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point is they need an open API.

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it turns out that most PIs never

anticipated you would have this

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slew of third party extremely

innovative applications, whether they

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be care plans or AI receptionists

or AI assisted radiology or just

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basically teleradiology or scribes.

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the list goes on and on that would

need to access your database.

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And What we're talking about a scenario

where a veterinarian, it's their data.

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dr--andy-roark-_1_02-27-2026_131235:

Right.

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squadcaster-eid5_1_02-27-2026_131158:

not their PIMS data.

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And right now many of the pims, most

of them, are not really facilitated to

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have all of these third party accesses

in a safe and sanctioned fashion

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with the volume that are coming out.

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And then you got, the next

thing is veterinarians want

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access to their own data.

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You wanna be able to, in the not

distant future, you wanna say, how

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many appointments did I have where the

client declined, heartworm testing.

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I

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dr--andy-roark-_1_02-27-2026_131235: Yeah.

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squadcaster-eid5_1_02-27-2026_131158:

the kind of thing that you should be

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able to ask your PIMS by just talking

to it and it can tell you that data

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that needs an API to do that, to be

able to access all that incredible data.

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So these pins never

anticipated this they are.

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In the veterinary industry, this

is unlike most other industries.

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There are three friction points

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dr--andy-roark-_1_02-27-2026_131235: Okay.

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squadcaster-eid5_1_02-27-2026_131158:

that are out there.

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The first is the PIMS never anticipated

of applications that needed access,

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so they don't have a very good

architecture to support all these

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new innovations that are coming.

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They can't handle the volume.

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dr--andy-roark-_1_02-27-2026_131235: Okay.

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squadcaster-eid5_1_02-27-2026_131158:

second.

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Is that sometimes they say, no,

you can't use a third party scribe

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because I want you to use my scribe.

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dr--andy-roark-_1_02-27-2026_131235: Yeah.

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squadcaster-eid5_1_02-27-2026_131158:

that's their kind of internal

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conflict of interest.

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And obviously, we believe that

customers should be able to use

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anything they want to access their data.

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And the best scribe should win, not based

on restricted access, but you know what?

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whatever is the best application.

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And the third is.

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the PIMS charges significant

dollars, way more than it, it costs

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them to provide the API access to

the per third party innovators.

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So basically they're monetizing access

to your data by charging the innovators,

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and of course that slows down innovation.

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We believe that all this innovation

one of the antidotes, the challenges.

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The profession is facing and we believe

that it's just really important that

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PIMS have an open, API philosophy

and support this innovation.

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And in this context,

PIMS will be competitive.

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dr--andy-roark-_1_02-27-2026_131235: So

when you say we, you mean the sort of the

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co-authors on the, on your recent paper?

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Is that correct?

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squadcaster-eid5_1_02-27-2026_131158:

So the paper that you were referring

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to is actually the fourth part in the

series that are all available on my.

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Co-authors, website, Adam

Masaki vet software hub.com.

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And, he's vendor neutral.

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He does all this free and so

he's a co-author along with,

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along with two other co-authors.

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And, we just believe that it's

really important that customers

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have access to their own data and

if they decide they wanna use.

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of these third party, or several, or

many of these third party applications,

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should have, those applications

should have access to their data.

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It's their data.

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It's not the PIMS data.

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dr--andy-roark-_1_02-27-2026_131235: What

is the argument the other side would make?

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so if, if the, the PIMS company

that's no, no, no, no, no, no, no.

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we really need to keep this clamp down.

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how would they justify that if you

were gonna steal man, their argument?

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What, how would, what would they say?

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squadcaster-eid5_1_02-27-2026_131158:

Okay, so that, that's

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a great question, Andy.

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I think the first thing they'd say is.

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this is very dangerous.

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This could, disrupt your pims.

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This could create a problem

with third party access.

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the PIMS wasn't designed, to

have this third party access.

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We don't want you to crash your PIs.

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By using a third party app

or we have a better scribe.

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We just know we have a better

scribe and you really don't

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dr--andy-roark-_1_02-27-2026_131235:

You really don't want, you

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really don't want that.

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squadcaster-eid5_1_02-27-2026_131158:

And by the way, our scribe works

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better because it's fully integrated

with the rest of the database.

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dr--andy-roark-_1_02-27-2026_131235:

I was gonna ask you about that.

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I'll come, I'm gonna come

back to that, but keep going.

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squadcaster-eid5_1_02-27-2026_131158:

Yeah.

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By the way, we've seen

no evidence of that.

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Okay.

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We don't, we can't actually

find medical or business case

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why that would be the case.

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I think the third is, we charge third

party innovators 'cause it costs us money.

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To do these integrations correctly.

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But what I will tell you is if you

look at general industry, whether

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it's a HubSpot, or salesforce.com

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or work, all of these

provide open and free access.

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So this, the veterinary is way behind.

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These are antiquated systems.

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They weren't designed, they never

had, for the most part, I don't

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wanna generalize completely.

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For the most part, they didn't have the

strategic vision that you were gonna have

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all of these apps, let alone the customer.

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Having their own app, they've

created their own vibe code.

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Someone said, I said, veterinarians

are gonna vibe code their own apps.

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And someone said, that's

never gonna happen.

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And now I've seen three

veterinarians do it.

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Okay.

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So it's like want access to their data.

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They don't want it to be restricted

to the workflows in the PIs.

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dr--andy-roark-_1_02-27-2026_131235: Yeah.

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So let's jump back to that real quick.

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'cause I heard that recently, I heard

people starting to differentiate

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for, this is all a new argument of

free, but there are, there are fully

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integrated, say AI scribes and then

there are native AI scribes, which

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were co-developed with the PIM system.

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And, the, the way I heard it

was they were like, oh, Fully

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integrated that's not native.

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And I just nodded my head, John.

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I don't know what that, I

don't know what that means.

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is that true?

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What is there, any benefit to

having something that's, native

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to a PIM system versus something

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squadcaster-eid5_1_02-27-2026_131158:

means that they've designed it

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so it has read access to the

medical record or whatever else

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it needs, and write access back.

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It just means they provided an API

to their own, but I will tell you.

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These leading scribes are so far

along in the development, this is you.

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This is not something you

can develop overnight.

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They

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dr--andy-roark-_1_02-27-2026_131235:

Right.

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squadcaster-eid5_1_02-27-2026_131158:

expanded their use cases

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geometrically, and so know, I

would put any home, if you will.

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Internally, pims are good at pims.

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They should focus on pims.

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They shouldn't try to branch out to

something like Scribe, where you've got,

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four or five scribe companies that are

way down the innovation curve because

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they've been focused exclusively on

this application for the last two years.

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And oh, by the way, they already have

adoption in 20, 25% of veterinarians.

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So what are you gonna tell a veterinarian?

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No, stop using the scribe you love because

you have to use our scribe because.

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gonna allow your scribe to write

back, the, soap notes to the medical

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record that just doesn't, sit right.

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dr--andy-roark-_1_02-27-2026_131235: I

jumped back to, I started practice in

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2008 and I remember when integration

between you, the PIM software

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and IDEXX was a pretty new thing.

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The idea that I wasn't

getting faxes anymore.

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and that blood work would

integrate into the PI system.

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Like I remember when that was new.

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I remember when IDEXX launched

VetConnect plus, which was this thing

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to share information with the pet

owners and I thought that was great.

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I'm a big advocate for

communicating with pet owners.

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But at that time, the PI system was.

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90% of sort of the information hub,

of what was running our practices.

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It was, when I thought about

how the practice worked,

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it was a huge piece of it.

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I was talking to someone recently

about multi-practice ownership,

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running multiple practices.

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And we talked about for a long time, the

biggest problem when you had multiple

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practices was if they weren't using the

same PIM system, it was such a nightmare

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because they didn't really talk to

each other and then you getting the

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practices to change was a real headache.

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And my friend was like, that's not a

problem anymore, Andy, because you can

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have the A, you can have an AI system

that lays over and draws this information.

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that really broke my brain.

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squadcaster-eid5_1_02-27-2026_131158:

change, which is not a pleasant

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experience for any practice.

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dr--andy-roark-_1_02-27-2026_131235:

Yeah, but that kind of broke my

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brain when I'm thinking about that.

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And John, I'm listening to you talk about,

and you're talking about sort of these

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assets that can come in from the outside.

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Do you see the PIM system

still being sort of.

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the center of the vet practice universe,

or are they really moving over to the side

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to even something that will lay on top of

them and, and provide a larger structure.

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I've heard people also say, Andy,

the AI scribes, that's what vets

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talk about, but that's just a

tiny piece of what's really there.

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can you dive into that a little bit?

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Is there sort of an AI component

to this that's much bigger

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than what I'm even imagining?

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squadcaster-eid5_1_02-27-2026_131158:

Yeah, there is an AI component.

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I want to come back to your reference to

VetConnect plus because I was actually

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the originator of the VetConnect plus,

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dr--andy-roark-_1_02-27-2026_131235:

Really

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squadcaster-eid5_1_02-27-2026_131158:

idea.

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Yeah, that was my idea in 2009

and IDEXX launched it in:

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And here's a simple fact, okay.

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Of course, IDX wants every

practice to have access to

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the incredible presentation.

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makes of the diagnostic results

and the ability to do the

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ordering all within the pims.

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It is the easiest to integrate.

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It's like the gold standard.

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I one vibe coder that I talked

to, veterinary, he integrated the

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IDEXX spec Connect Plus overnight.

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It's that simple.

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Now, this is an app from Beck Neck Plus

into the PIs, but it just shows that

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this, there's these excuses that it's

difficult, you know, it's dangerous.

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And by the way, this is both read

and write, so it's presenting

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all the diagnostic results and

you can order, through the PIs.

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So it's got right.

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Back to, that Connect Plus and the

other diagnostic companies have done

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similar things because it's in their

interest to make sure the diagnostic

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data, they're not relying on the

PIMS who know nothing about medicine

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dr--andy-roark-_1_02-27-2026_131235: Yeah.

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squadcaster-eid5_1_02-27-2026_131158:

these highly technical results.

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They want, they wanna

present them in the value.

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yes, to answer your question, I think

the scribes are just the beginning

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of an incredible in credible wave

of innovation that's already.

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Just, you know, in.

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dr--andy-roark-_1_02-27-2026_131235: I

was listening to a, an interview around

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AI recently and someone was saying,

look, we are, we in this, we are in

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this phase right now when you look at

AI in the larger population and there's

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a lot of people who are starting to

use AI for nefarious purposes, right?

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My, the number of spam phone

calls I get has gone way up.

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The spam emails or phishing

emails are much better than they

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used to be and things like that.

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Is there any concern when we

talk about sharing, read, write,

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access of veterinarians would.

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integrate something that is bad,

something that, that could corrupt

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or destroy their medical records.

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I know veterans are very protective

of this and they really like, losing

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your medical records, for example.

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we've heard of malware, attacks

where vet practices are held hostage.

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do you have significant concerns

about bad actors in this space?

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squadcaster-eid5_1_02-27-2026_131158:

I think it's an important, it's

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an important caution and I think,

if a practice is evaluating a new.

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Say a scribe or one of these others,

they should do a lot of due diligence on

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dr--andy-roark-_1_02-27-2026_131235: Yeah.

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squadcaster-eid5_1_02-27-2026_131158:

In fact, my colleague Adam Waki,

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the whole purpose of his website

is how to buy software and

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what are the questions to ask?

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But these reputable companies,

this would kill their business

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:

model instantaneously if it

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dr--andy-roark-_1_02-27-2026_131235: Yeah.

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squadcaster-eid5_1_02-27-2026_131158:

kind of, security error.

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I think, once they.

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They have a credible, install base and,

and they talk about the right protections.

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I really don't think it's a concern

of, remember you are making the

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practice owner is making the decision,

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dr--andy-roark-_1_02-27-2026_131235: Yeah.

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squadcaster-eid5_1_02-27-2026_131158:

and they have control over it.

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whether they want this app to have access

and they get to see how it operates.

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dr--andy-roark-_1_02-27-2026_131235: I

wanna encourage you to dream here for a

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second because you see all of this at a

level that, that most people just don't.

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And I just, that's why I

like to read your writing.

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I just, I think that you're

prescient in a lot of ways.

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Granted, the world is changing

fast and there's so many factors.

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It's hard to know, but John.

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When you look into the future, your

crystal ball and you see the next

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generation of PIM systems of just

of technology inside the vet clinic,

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what does that look like to you?

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What do you hope for in terms of

how the clinic functions, the client

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:

experience, maybe the team experience?

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are there pieces there that,

that gets you excited about?

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:

What's possible?

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squadcaster-eid5_1_02-27-2026_131158:

Oh, I think it's huge, first of all.

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and there's been studies on this.

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The role of the veterinarian

and the role of the tech.

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This is not going away.

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This is not gonna be replaced by a,

you cannot replace a physical, exam.

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You cannot replace an in-person

conversation with a pet on about

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what the right course of action is.

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considering the options, the spectrum of

care, you know, whether you wanna go, one

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:

way or another, depending on the cost.

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:

You can't, I don't think you can

change that, but what the tasks.

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Will change.

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I think AI will significantly eliminate

the drudgery increase the value, added

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:

the domain expertise, if we call of

the veterinarian and the tech, this is

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promises to be an incredible advancement

in the quality of care and, eliminating

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:

all of this administration that.

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Generally people don't even think

about, but take so much of their time.

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:

So I I think properly implemented

and I believe the practices who adopt

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early and start gaining experience,

they get the compounding advantage.

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And I think it's really the solution

to the challenges we're seeing a year

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:

over year decline in, veterinary visits.

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I mean, this is, we're we're

entering our fifth year of declines

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:

in veterinary visits off the

peak in veterinary visits early.

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Lower than they were in the 2018 and 2019.

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And the industry needs to grapple with.

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I do believe the adoption of technology

one of the significant antidotes to that.

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:

dr--andy-roark-_1_02-27-2026_131235:

John, thank you so much for sitting

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down and talking through this with me.

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I always love to hear your thoughts.

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:

where can people find you online?

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where can they keep up with your writing?

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squadcaster-eid5_1_02-27-2026_131158: I'm

on LinkedIn and I post a number of things.

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also Catalyst Council.

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I'm chair of the Market Insights We

do a lot of research for our sponsors,

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:

but we also publish, press releases

on the high level conclusions.

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And then the four papers that you

mentioned are on vet software hub, and

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we're gonna have a few more in the works.

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And we're gonna, I don't wanna say

all, I think pims, I think several

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forward PIs beginning to realize the

importance that they're placing, that

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:

they're, that they have as a database.

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:

That is the customer's database,

and they can provide the mechanisms

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:

and the, the, the read and

write access to this innovation.

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:

I'm not sure all pims are

gonna be able to do that.

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I'm not sure all pims are gonna survive,

but somebody's gotta keep the database

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:

of, pets appointments and whatnot.

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:

dr--andy-roark-_1_02-27-2026_131235:

John, if you were a veterinarian

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:

and you were, so let's just say that

you were starting a new practice.

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:

you are part of the golden resurgence

that we're seeing in independent

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:

practice ownership, and it's time for

you to pick out your PIM system that

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:

you're gonna build your practice on.

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:

What is the most important question

that you think you would ask?

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:

squadcaster-eid5_1_02-27-2026_131158: I

would like to know, a, the robustness,

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:

because I think the real value.

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:

A is their database, their ability

to manage access to the database.

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:

I'd like to know the robustness of

their database and their architecture.

446

:

Again, these are questions that Adam

Masaki has on the vet software hub.

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:

that's the most important because the

workflow is going to change with ai.

448

:

you need a basic workflow.

449

:

Of course you can evaluate it based on

the workflow, but I think pretty screens.

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:

Without really understanding, it's

your data that this information

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:

management system is going to

manage is, a superficial analysis.

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:

So really understanding A, what is the

underlying structure, and B, what is

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:

their philosophy about open systems, APIs.

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:

I think, some important questions

that now as a result of the work

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:

we're doing, everybody's beginning

to recognize and I think some of the.

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Are pivoting.

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:

dr--andy-roark-_1_02-27-2026_131235:

Outstanding.

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:

John, thanks again for being here guys.

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Thanks for tuning in and listening.

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:

Everybody take care of yourself, gang.

461

:

And that's what I got guys.

462

:

Thanks for being here.

463

:

Thanks to John Ayers for being here, gang.

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if you enjoyed the episode,

share it with your friends.

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:

like us, rate Us, review us.

466

:

All of those things are huge.

467

:

Helps.

468

:

It helps people find the podcast.

469

:

but anyway, yeah, take a moment

and, and share this episode with

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:

somebody who'd find it interesting.

471

:

Anyway, guys, I appreciate you.

472

:

Take care of yourselves.

473

:

I'll talk to you later on.

474

:

Bye.

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The Cone of Shame Veterinary Podcast
The Cone of Shame Podcast is the podcast all about life in Veterinary Medicine. Dr Andy Roark covers medical related topics with help from experts in the veterinary industry.

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