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!

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

Welcome everybody to the Kone

2

of Shame Veterinary podcast.

3

I am your host, Dr.

4

And Dewar.

5

Guys, I got a great one today.

6

This is a mind bender.

7

and I am here with John Ayers,

the former chair and CEO of

8

Idexx, and he is writing a lot.

9

And thinking a lot about AI and how

it's gonna interact with our PIM system.

10

And I know that probably doesn't sound

like the sexiest topic right off the top.

11

I appreciate you clicking on the podcast

and listening when you saw PIMS and AI and

12

you're here you are and I appreciate it.

13

And lemme tell you, this is

totally worth your time and effort.

14

Guys, the PIM system is the heart

and soul of a lot of our ve.

15

It's not the soul.

16

It's the heart of a lot

of our vet, practices.

17

It is, the, it's where a

lot of our work gets done.

18

The way that we interact with

it makes up a lot of our day.

19

it either helps or hinders our

efficiency and getting things

20

done, like it really plays a huge

role in getting medicine done and.

21

I am fascinated with how AI is going

to fundamentally change the way

22

we interact with the PIM system.

23

How is this AI thing gonna

actually make our lives better?

24

That's what we get into

with John Airs today.

25

It's really, really interesting.

26

He's got a really neat vision of

where this all goes, and I think

27

he's, Appropriately pragmatic.

28

he, he's very much like

everything is moving fast.

29

It's hard to tell, but these are

the things that are important

30

and this is where it's going.

31

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

he's got excellent clarity, insight.

32

He definitely affected my thinking on

I sort this topic and what the short

33

term future in vet medicine looks like.

34

And I really tried to bring this down

Very much to the practice level, to try

35

to get in my head around what's it gonna

be like when I'm seeing appointments?

36

what does this mean?

37

Anyway, this is a really

good episode, guys.

38

I hope that you're going to enjoy it.

39

Let's get into it.

40

Kelsey Beth Carpenter: This is your show.

41

We're glad you're here.

42

We want to help you in

your veterinary career.

43

Welcome to the Cone of Shame with Dr.

44

Andy Roark.

45

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

Welcome to the podcast, John Ayers.

46

Thank you for being here, my friend.

47

squadcaster-eid5_1_02-27-2026_131158:

Thank you, Andy.

48

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

It is a real, it's a real

49

honor to have you here.

50

For those who don't know you, you are

the former chair and CEO at idexx.

51

you are also, currently a board

member at Catalyst Council, which

52

is a nonprofit organization focused

on the wellness and benefits of.

53

Katz, you are fairly prolific writer.

54

I like to read, your stuff a lot.

55

I follow you on LinkedIn.

56

You've had a number of articles and

posts that have been coming out.

57

there's a million things

I could talk to you about.

58

I just, I think your work around, around

access to care one is interesting.

59

access to care specifically for

cats I think is interesting, but

60

I wanna get in today and talk to

you a little bit about some of the

61

stuff you've been writing around ai.

62

Inside of veterinary practice

and so you have an article.

63

The article is, titled, so

it's a whopper of a title.

64

It's Companion Animal veterinary software.

65

Pims in the age of ai, colon

weather, the storm or withered.

66

I really like the subtext, what becomes

of the veterinary PIMS in the world of ai.

67

And that's what I was really interested.

68

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

think that you are thinking about this at

69

a level that I haven't seen anybody else

really get in the weeds and think about.

70

And can you go ahead and just,

let's just start at a high level.

71

I'm gonna say most of the people who

listen to this podcast are very familiar

72

with the veterinary PIM system, right?

73

It's the practice management, system.

74

it's our information

systems and our practices.

75

This is the nerve center

for most vet practices.

76

John, where do you see this, the

PIM system in say, five to 10 years?

77

have some pretty, pretty big ideas

about how that's gonna be different.

78

Can you paint me a picture

of of what you're expecting?

79

squadcaster-eid5_1_02-27-2026_131158:

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

80

figure out the next year or two because

things are moving so fast in ai.

81

for those that are not familiar,

there's something called the SaaS

82

apocalypse, which is software

as a service is being completely

83

upended, in the general markets.

84

companies that are big SaaS

companies like Salesforce and

85

HubSpot's down 75% from their peak.

86

everybody is wondering

what is the future of SaaS?

87

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

88

squadcaster-eid5_1_02-27-2026_131158:

so now we, we bring ourselves

89

to veterinary medicine.

90

Now, of course, not all PIMS or

PIMS are software as a service.

91

Many of them are still working

quite well as, server-based or

92

what's called on-premise.

93

and I think close to half of

the industry still on premise.

94

But if you look at the basic.

95

Role a pims, and this is,

really important to understand.

96

It's two things.

97

First of all, it's your data.

98

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

99

squadcaster-eid5_1_02-27-2026_131158:

It's your medical records, it's

100

your schedule, it's your, inventory.

101

Your client communications, your

service, and product charges.

102

it's, your cash register.

103

it's your boarding and grooming it.

104

There's a lot in there which are

basically made up of databases.

105

And databases are important because

you can't schedule two appointments

106

in the same appointment slot.

107

Okay?

108

So the PIMS has to keep

track of all of this.

109

Particularly the pet owner data.

110

But all of these datas, this is what's

therefore called in industry parlance, or

111

technology parlance, the system of record.

112

So it is the single canonical, place

where your data is stored, and you

113

know the data, the pims make sure

there's not two entries for the same

114

pad, or two appointments and the same

appointment slot and that kind of thing.

115

The second role that your,

PIs play, it's its workflow.

116

It helps you update those databases with

workflow, putting charges in from the

117

appointment or scheduling appointments.

118

all of those things are what

we'd call applications that

119

help the practice their data.

120

Okay, so now in the world, this

is important to understand.

121

a database and it's a set of applications.

122

Now, most pims were

never actually designed.

123

They were designed as one big,

everything merged together.

124

Okay?

125

But now in the age of ai, there are all

these different applications veterinarians

126

are adopting want me and need access.

127

That systems of record.

128

So you may have adopted the simplest ones.

129

You may have adopted a scribe and you

want the scribe to be able to read

130

from the medical record and to be

able to, with approval and the right,

131

oversight, be able to write back, to

the medical record or charges that were

132

talked about during the appointment.

133

So these are called

read and write accesses,

134

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

135

squadcaster-eid5_1_02-27-2026_131158:

those read and write accesses are.

136

facilitated by what's called an API

or application program interface.

137

And I promise I'll give no

more technical jargon, but the

138

point is they need an open API.

139

it turns out that most PIs never

anticipated you would have this

140

slew of third party extremely

innovative applications, whether they

141

be care plans or AI receptionists

or AI assisted radiology or just

142

basically teleradiology or scribes.

143

the list goes on and on that would

need to access your database.

144

And What we're talking about a scenario

where a veterinarian, it's their data.

145

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

Right.

146

squadcaster-eid5_1_02-27-2026_131158:

not their PIMS data.

147

And right now many of the pims, most

of them, are not really facilitated to

148

have all of these third party accesses

in a safe and sanctioned fashion

149

with the volume that are coming out.

150

And then you got, the next

thing is veterinarians want

151

access to their own data.

152

You wanna be able to, in the not

distant future, you wanna say, how

153

many appointments did I have where the

client declined, heartworm testing.

154

I

155

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

156

squadcaster-eid5_1_02-27-2026_131158:

the kind of thing that you should be

157

able to ask your PIMS by just talking

to it and it can tell you that data

158

that needs an API to do that, to be

able to access all that incredible data.

159

So these pins never

anticipated this they are.

160

In the veterinary industry, this

is unlike most other industries.

161

There are three friction points

162

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

163

squadcaster-eid5_1_02-27-2026_131158:

that are out there.

164

The first is the PIMS never anticipated

of applications that needed access,

165

so they don't have a very good

architecture to support all these

166

new innovations that are coming.

167

They can't handle the volume.

168

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

169

squadcaster-eid5_1_02-27-2026_131158:

second.

170

Is that sometimes they say, no,

you can't use a third party scribe

171

because I want you to use my scribe.

172

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

173

squadcaster-eid5_1_02-27-2026_131158:

that's their kind of internal

174

conflict of interest.

175

And obviously, we believe that

customers should be able to use

176

anything they want to access their data.

177

And the best scribe should win, not based

on restricted access, but you know what?

178

whatever is the best application.

179

And the third is.

180

the PIMS charges significant

dollars, way more than it, it costs

181

them to provide the API access to

the per third party innovators.

182

So basically they're monetizing access

to your data by charging the innovators,

183

and of course that slows down innovation.

184

We believe that all this innovation

one of the antidotes, the challenges.

185

The profession is facing and we believe

that it's just really important that

186

PIMS have an open, API philosophy

and support this innovation.

187

And in this context,

PIMS will be competitive.

188

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

when you say we, you mean the sort of the

189

co-authors on the, on your recent paper?

190

Is that correct?

191

squadcaster-eid5_1_02-27-2026_131158:

So the paper that you were referring

192

to is actually the fourth part in the

series that are all available on my.

193

Co-authors, website, Adam

Masaki vet software hub.com.

194

And, he's vendor neutral.

195

He does all this free and so

he's a co-author along with,

196

along with two other co-authors.

197

And, we just believe that it's

really important that customers

198

have access to their own data and

if they decide they wanna use.

199

of these third party, or several, or

many of these third party applications,

200

should have, those applications

should have access to their data.

201

It's their data.

202

It's not the PIMS data.

203

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

is the argument the other side would make?

204

so if, if the, the PIMS company

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

205

we really need to keep this clamp down.

206

how would they justify that if you

were gonna steal man, their argument?

207

What, how would, what would they say?

208

squadcaster-eid5_1_02-27-2026_131158:

Okay, so that, that's

209

a great question, Andy.

210

I think the first thing they'd say is.

211

this is very dangerous.

212

This could, disrupt your pims.

213

This could create a problem

with third party access.

214

the PIMS wasn't designed, to

have this third party access.

215

We don't want you to crash your PIs.

216

By using a third party app

or we have a better scribe.

217

We just know we have a better

scribe and you really don't

218

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

You really don't want, you

219

really don't want that.

220

squadcaster-eid5_1_02-27-2026_131158:

And by the way, our scribe works

221

better because it's fully integrated

with the rest of the database.

222

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

I was gonna ask you about that.

223

I'll come, I'm gonna come

back to that, but keep going.

224

squadcaster-eid5_1_02-27-2026_131158:

Yeah.

225

By the way, we've seen

no evidence of that.

226

Okay.

227

We don't, we can't actually

find medical or business case

228

why that would be the case.

229

I think the third is, we charge third

party innovators 'cause it costs us money.

230

To do these integrations correctly.

231

But what I will tell you is if you

look at general industry, whether

232

it's a HubSpot, or salesforce.com

233

or work, all of these

provide open and free access.

234

So this, the veterinary is way behind.

235

These are antiquated systems.

236

They weren't designed, they never

had, for the most part, I don't

237

wanna generalize completely.

238

For the most part, they didn't have the

strategic vision that you were gonna have

239

all of these apps, let alone the customer.

240

Having their own app, they've

created their own vibe code.

241

Someone said, I said, veterinarians

are gonna vibe code their own apps.

242

And someone said, that's

never gonna happen.

243

And now I've seen three

veterinarians do it.

244

Okay.

245

So it's like want access to their data.

246

They don't want it to be restricted

to the workflows in the PIs.

247

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

248

So let's jump back to that real quick.

249

'cause I heard that recently, I heard

people starting to differentiate

250

for, this is all a new argument of

free, but there are, there are fully

251

integrated, say AI scribes and then

there are native AI scribes, which

252

were co-developed with the PIM system.

253

And, the, the way I heard it

was they were like, oh, Fully

254

integrated that's not native.

255

And I just nodded my head, John.

256

I don't know what that, I

don't know what that means.

257

is that true?

258

What is there, any benefit to

having something that's, native

259

to a PIM system versus something

260

squadcaster-eid5_1_02-27-2026_131158:

means that they've designed it

261

so it has read access to the

medical record or whatever else

262

it needs, and write access back.

263

It just means they provided an API

to their own, but I will tell you.

264

These leading scribes are so far

along in the development, this is you.

265

This is not something you

can develop overnight.

266

They

267

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

Right.

268

squadcaster-eid5_1_02-27-2026_131158:

expanded their use cases

269

geometrically, and so know, I

would put any home, if you will.

270

Internally, pims are good at pims.

271

They should focus on pims.

272

They shouldn't try to branch out to

something like Scribe, where you've got,

273

four or five scribe companies that are

way down the innovation curve because

274

they've been focused exclusively on

this application for the last two years.

275

And oh, by the way, they already have

adoption in 20, 25% of veterinarians.

276

So what are you gonna tell a veterinarian?

277

No, stop using the scribe you love because

you have to use our scribe because.

278

gonna allow your scribe to write

back, the, soap notes to the medical

279

record that just doesn't, sit right.

280

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

jumped back to, I started practice in

281

2008 and I remember when integration

between you, the PIM software

282

and IDEXX was a pretty new thing.

283

The idea that I wasn't

getting faxes anymore.

284

and that blood work would

integrate into the PI system.

285

Like I remember when that was new.

286

I remember when IDEXX launched

VetConnect plus, which was this thing

287

to share information with the pet

owners and I thought that was great.

288

I'm a big advocate for

communicating with pet owners.

289

But at that time, the PI system was.

290

90% of sort of the information hub,

of what was running our practices.

291

It was, when I thought about

how the practice worked,

292

it was a huge piece of it.

293

I was talking to someone recently

about multi-practice ownership,

294

running multiple practices.

295

And we talked about for a long time, the

biggest problem when you had multiple

296

practices was if they weren't using the

same PIM system, it was such a nightmare

297

because they didn't really talk to

each other and then you getting the

298

practices to change was a real headache.

299

And my friend was like, that's not a

problem anymore, Andy, because you can

300

have the A, you can have an AI system

that lays over and draws this information.

301

that really broke my brain.

302

squadcaster-eid5_1_02-27-2026_131158:

change, which is not a pleasant

303

experience for any practice.

304

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

Yeah, but that kind of broke my

305

brain when I'm thinking about that.

306

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

and you're talking about sort of these

307

assets that can come in from the outside.

308

Do you see the PIM system

still being sort of.

309

the center of the vet practice universe,

or are they really moving over to the side

310

to even something that will lay on top of

them and, and provide a larger structure.

311

I've heard people also say, Andy,

the AI scribes, that's what vets

312

talk about, but that's just a

tiny piece of what's really there.

313

can you dive into that a little bit?

314

Is there sort of an AI component

to this that's much bigger

315

than what I'm even imagining?

316

squadcaster-eid5_1_02-27-2026_131158:

Yeah, there is an AI component.

317

I want to come back to your reference to

VetConnect plus because I was actually

318

the originator of the VetConnect plus,

319

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

Really

320

squadcaster-eid5_1_02-27-2026_131158:

idea.

321

Yeah, that was my idea in 2009

322

And here's a simple fact, okay.

323

Of course, IDX wants every

practice to have access to

324

the incredible presentation.

325

makes of the diagnostic results

and the ability to do the

326

ordering all within the pims.

327

It is the easiest to integrate.

328

It's like the gold standard.

329

I one vibe coder that I talked

to, veterinary, he integrated the

330

IDEXX spec Connect Plus overnight.

331

It's that simple.

332

Now, this is an app from Beck Neck Plus

into the PIs, but it just shows that

333

this, there's these excuses that it's

difficult, you know, it's dangerous.

334

And by the way, this is both read

and write, so it's presenting

335

all the diagnostic results and

you can order, through the PIs.

336

So it's got right.

337

Back to, that Connect Plus and the

other diagnostic companies have done

338

similar things because it's in their

interest to make sure the diagnostic

339

data, they're not relying on the

PIMS who know nothing about medicine

340

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

341

squadcaster-eid5_1_02-27-2026_131158:

these highly technical results.

342

They want, they wanna

present them in the value.

343

yes, to answer your question, I think

the scribes are just the beginning

344

of an incredible in credible wave

of innovation that's already.

345

Just, you know, in.

346

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

was listening to a, an interview around

347

AI recently and someone was saying,

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

348

this phase right now when you look at

AI in the larger population and there's

349

a lot of people who are starting to

use AI for nefarious purposes, right?

350

My, the number of spam phone

calls I get has gone way up.

351

The spam emails or phishing

emails are much better than they

352

used to be and things like that.

353

Is there any concern when we

talk about sharing, read, write,

354

access of veterinarians would.

355

integrate something that is bad,

something that, that could corrupt

356

or destroy their medical records.

357

I know veterans are very protective

of this and they really like, losing

358

your medical records, for example.

359

we've heard of malware, attacks

where vet practices are held hostage.

360

do you have significant concerns

about bad actors in this space?

361

squadcaster-eid5_1_02-27-2026_131158:

I think it's an important, it's

362

an important caution and I think,

if a practice is evaluating a new.

363

Say a scribe or one of these others,

they should do a lot of due diligence on

364

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

365

squadcaster-eid5_1_02-27-2026_131158:

In fact, my colleague Adam Waki,

366

the whole purpose of his website

is how to buy software and

367

what are the questions to ask?

368

But these reputable companies,

this would kill their business

369

model instantaneously if it

370

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

371

squadcaster-eid5_1_02-27-2026_131158:

kind of, security error.

372

I think, once they.

373

They have a credible, install base and,

and they talk about the right protections.

374

I really don't think it's a concern

of, remember you are making the

375

practice owner is making the decision,

376

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

377

squadcaster-eid5_1_02-27-2026_131158:

and they have control over it.

378

whether they want this app to have access

and they get to see how it operates.

379

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

wanna encourage you to dream here for a

380

second because you see all of this at a

level that, that most people just don't.

381

And I just, that's why I

like to read your writing.

382

I just, I think that you're

prescient in a lot of ways.

383

Granted, the world is changing

fast and there's so many factors.

384

It's hard to know, but John.

385

When you look into the future, your

crystal ball and you see the next

386

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.

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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.

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you need a basic workflow.

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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.

460

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.

464

if you enjoyed the episode,

share it with your friends.

465

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

470

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.