AAHA data shows 17% of lab tests go unbilled, and server-based PIMS are part of the reasonMount Pearl animal hospital closes after 39 years citing veterinarian shortageFront-desk checkout averages seven to 10 minutes, in-room checkout takes two to fiveAAHA splits diabetes management guidelines into separate canine and feline editionsPetMetrix releases free report tracking 22 months of new competition in pet prescriptionsMerck launches non-adjuvanted rabies vaccine line with half-milliliter dose82 dogs with B-cell lymphoma lived a median 660 days after CHOP plus adoptive T-cell therapyMontana practice hired an associate to split on-call dutyAAHA data shows 17% of lab tests go unbilled, and server-based PIMS are part of the reasonMount Pearl animal hospital closes after 39 years citing veterinarian shortageFront-desk checkout averages seven to 10 minutes, in-room checkout takes two to fiveAAHA splits diabetes management guidelines into separate canine and feline editionsPetMetrix releases free report tracking 22 months of new competition in pet prescriptionsMerck launches non-adjuvanted rabies vaccine line with half-milliliter dose82 dogs with B-cell lymphoma lived a median 660 days after CHOP plus adoptive T-cell therapyMontana practice hired an associate to split on-call duty
The Exam RoomBy The VeterinaryPracticeNow Desk3 min readNovember 4, 2026
AAHA data shows 17% of lab tests go unbilled, and server-based PIMS are part of the reason
AAHA research found 17% of lab tests went unbilled, and veterinarians spend 30-40% of working hours on documentation.
This article covers sponsored content from Instinct EMR.
Server-based practice management systems create costs that never appear on the software invoice. Hours lost to downtime, missed charges from disconnected workflows, after-hours documentation, and IT maintenance show up elsewhere in the P&L.
A new guide from Instinct EMR, The Hidden Costs of Legacy Veterinary Software, walks practices through calculating what a server-based system costs beyond the monthly bill. The guide is sponsored content promoting Instinct's cloud-based PIMS, but the cost-accounting framework it lays out applies to any legacy-system evaluation.
Calculating downtime cost
The guide recommends a baseline calculation: "multiply it by the number of hours a significant outage could take you offline," according to the guide. That figure is the starting point, not the total.
When a server goes down, the practice loses "access to schedules, patient records, treatment sheets, and checkout," the guide states. The financial impact includes the revenue per hour the practice runs while offline, the appointments that need rescheduling, and the charges completed from memory that never make it onto the invoice.
Missed charges and the AAHA data
When a PIMS does not connect with the other technology in use, the guide notes that "people have to fill the gaps. Lab results" get printed and scanned. Information gets entered more than once. Controlled-substance logs need manual oversight. Each step in that chain takes time and opens another point where information or revenue can slip through.
Missed charges are one example. The guide cites AAHA research showing "that 17% of lab tests went unbilled by practices," according to the AAHA findings. The source does not provide the sample size or methodology behind that figure, so we cannot assess how representative it is, but the direction is consistent with what we hear from practices running disconnected systems. The guide explains that "when capturing a charge depends on someone remembering to add it after a busy appointment, some of the care you've already provided may never make it onto the client invoice."
After-hours documentation burden
The guide cites the 2024 State of Veterinary Wellbeing report, which found that veterinarians spend an estimated "30-40% of their working hours on medical record documentation," according to the report. The report names after-hours charting and redundant data entry as contributors to burnout. Again, the source does not give the sample size or survey design, so the figure is directional rather than a controlled finding.
The guide describes systems that create problems as "software that adds unnecessary steps, requires extensive training, or makes everyday tasks harder." Those systems create costs that extend beyond technology. The guide asks practices to evaluate how much work the system requires "simply to keep information moving," according to the guide: duplicate entry, workarounds instead of direct workflows, and the time it takes a new employee or relief veterinarian to become productive.
Hardware and IT maintenance costs
Older, server-based systems create expenses in hardware and IT maintenance, disconnected workflows, difficulty integrating with new tools, and security updates. The guide lists "downtime, hardware upgrades, security updates, manual workflows, disconnected systems, training inefficiencies, and growth limitations" as contributors to the total cost of keeping a legacy system in place, according to Instinct.
The amount on the billing statement is the visible part. The larger cost shows up in the hours your team spends working around the system, the charges that never get captured, the after-hours documentation that eats into personal time, and the revenue lost every time the server goes down.
When you evaluate a current system, the comparison is not subscription price to subscription price. It is total cost of ownership: the software bill plus the downtime, the IT calls, the missed charges, the duplicate entry, and the unpaid hours your team spends filling the gaps the system leaves.
Instinct's guide argues that a cloud-based PIMS eliminates the server, the hardware refresh cycle, and the IT maintenance. We would add that it does not eliminate the need to train staff or the discipline required to capture charges consistently, but it does remove the structural costs that server-based systems create by design.
The figure to bring to the next budget conversation: add the downtime estimate, the missed-charge figure, and the after-hours documentation burden to the monthly software bill, then compare that total to what a cloud system would cost. The guide is built to make that case for Instinct's product, but the cost-accounting framework works for any legacy-versus-cloud decision.
Get the next issue in your inbox. Free, weekly, no fluff.
