Slowness Checklist

We strongly suggest being on the latest version of Cornerstone for best performance and up-to-date troubleshooting. For older Cornerstone versions, if additional troubleshooting is needed to address slowness, one of our recommendations will be to upgrade to Cornerstone. Visit the Upgrade Resources page for more info on upgrading.

Slowness is determined if a setting in Cornerstone takes over 10 seconds to function correctly. Anything under 10 seconds is expected behavior.

Please review the General Recommendations and Hardware and OS Recommendations before proceeding to the basic troubleshooting for slowness section below. If your hardware or OS are not setup to IDEXX standards the troubleshooting steps below will not resolve your issues.

If you are experiencing slowness outside of Cornerstone you will need to work with IDEXX Hardware Support and/or your Local IT. IDEXX Hardware Support can be reached at: 1-800-695-2877 option 2, option 3.

General recommendations

Business-class computers, printers, and peripherals

IDEXX recommends you use business-class computers, printers, and peripherals to ensure the best performance, reliability, and warranty. Business-class devices are available from manufacturers like Dell and include components, configuration options, and a warranty designed to meet the needs of a demanding business environment. Home versions are not recommended or supported.

Gigabit-speed wired networks

IDEXX recommends you use computers and switches capable of gigabit speed with a wired connection. Gigabit network speeds require CAT5e or better cabling. A wired connection will always provide a faster and more stable Cornerstone experience. A wireless connection should be used only for mobile computers.

Hardware and Operating System recommendations

• Hardware and Operating System guidelines
• Computer maintenance routines
• Hardware guidelines
• Windows 11 recommended settings
• Windows 10 recommended settings
• Windows Server 2022 recommended settings
• Windows Server 2019 recommended settings
• Windows Server 2016 recommended settings

Prior to troubleshooting, please verify:

1. The Cornerstone Database Server is configured per recommended OS settings
   • Hardware and Operating System guidelines
   • Firewall configuration guide
2. All Cornerstone Database Services are running on your server
   • Locate the Cornerstone Database Services icon on your server desktop or within the Cornerstone folder
3. The Cornerstone PDF printer is installed and functioning
   • For Windows 10:
     • Search for Control Panel
     • Choose Devices and Printers
     • Locate CS PDF Printer
     • Right click the CS PDF printer and choose printer properties
     • Click Print Test Page
       • A message that a test page has been sent to your printer should open along with a save as window.
       • If you get an error, please reach out to Cornerstone Support for help troubleshooting.
   • For Windows 11:
     • Right Click the Windows Icon
     • Click Settings
     • Click Bluetooth and Printers
     • Click Printers and Scanners
     • Click Cornerstone PDF Printer
     • Click Print Test Page
       • A message that a test page has been sent to your printer should open along with a save as window.
       • If you get an error, please reach out to Cornerstone Support for help troubleshooting.
4. Printer assignments are set: Printing General Settings and Printer Assignments.
5. Windows default printer is set: Printing General Settings and Printer Assignments.
6. Windows Print Spooler is running in services.msc
   • Right-click on the windows icon and select Run
   • Type services.msc and click OK
   • Locate the Print Spooler Service
   • If running, right click printer spooler to stop the service and then test Cornerstone performance. If the slowness resolves, it is a sign there is an issue with an installed printer.
     • If your printer was purchased through IDEXX and you have hardware support, the support team can review the printer setup and update the print driver, if necessary. Hardware support can be reached at 1-800-695-2877, option 2, option 3.
     • If your printer was purchased outside of IDEXX, please work with your local IT support to verify setup and update the print driver, if necessary.
     • Be sure to restart the print spooler service once testing is complete.
7. Server and workstation uptime
   • We suggest weekly restarts of your server and workstations.
     • Please note: Shutting down a computer is not the same as restarting it. It is okay to shut down your computer every night, but be sure to restart it at least once during the week.
   • Please allow Windows updates to run regularly for the best performance.

Basic troubleshooting by location of slowness:

Opening the Patient Clipboard

If using IDEXX-PACS, open a Patient Clipboard and click the “Hide IDEXX-PACS Images” checkbox. This setting will prevent the time it takes to load patient images in the background when viewing a Patient Clipboard with images. To access images, uncheck the “Hide IDEXX-PACS Images” checkbox.

On opening the Appointment Scheduler

• Large suites of 16+ rooms may cause slowness. We suggest using additional suites if this is your setup and you are experiencing slowness.
• We recommend setting the Appointment Scheduler screen refresh rate to at least 60-90+ seconds. A rate below 60 may slow your system down more. Navigate to Controls > Defaults > Practice and Workstation > Appointment Scheduler to adjust the Appointment Scheduler screen refresh rate.

• Verify the Windows default printer is set to the Cornerstone PDF printer.
• Open services.msc and verify the print spooler service is running. If you stop this service and performance improves in Cornerstone it is a sign there is an issue with an installed printer. See detailed instructions above.

 On appointment check-in

• Verify the Windows default printer set to the Cornerstone PDF printer.
• Set printer assignments in Cornerstone to Cornerstone PDF printer. See printing general settings and printer assignments for more information.
• If above is set and you are no longer having problems the issue could be related to a printer driver.

On check-in/out and/or invoicing

• If you use IDEXX-PACS, navigate to Controls > Defaults > Practice and Workstation > Imaging and verify the Connection Timeout is set to 5. If not, please update this setting and click apply.

• Cornerstone support can review further setup information for IDEXX-PACS and WebPACS if the above step does not resolve.

On opening document templates

• Disable the antivirus to test performance. See firewall configuration guide to ensure your exceptions are correct.
• Confirm Windows default printer is set to Cornerstone PDF Printer.
• Ensure printer assignments are set to Cornerstone PDF Printer.
• Open services.msc and verify the print spooler service is running. See detailed instructions above. If you stop this service and performance improve, it is a sign there is an issue with an installed printer.
• We suggest creating document templates that are 5MB or less for best performance. Cornerstone support can help determine the size of your document templates.

On opening document templates with images or illustrations

• Remove the images from your document template, open them in Windows Paint (or a similar program), choose resize, and reduce the size. Save the resized image and add it back to the document template.
• Break down documents with many images to more than one document.
• We recommend document templates be no larger than 5MB for best performance. Cornerstone Support can help determine the size of your documents.
• We see this issue most frequently with dental document templates due to the medical illustration sizes.
• IDEXX has provided a library of medical illustrations accessible on your server through C: > Cstone > Images > Medical Illustrations or call Cornerstone Support for additional help.

Patient History Report freezing and/or crashing

• Add date range filters.
• De-select history options

Lab requests slow to transfer or not transferring to the IDEXX VetLab Station (IVLS)

• If the Cornerstone icon on your IDEXX Vet Lab Station is showing offline, call Cornerstone support to troubleshoot.

• At the top of your IDEXX Vet Lab Station there will be two arrows that have a green or red dot next to them. If this dot is red, please contact our Integration team at: 1-800-248-2483.
  

On running end of day (EOD) or end of month (EOM)

• Open the Daily Planner Medical Note/Correspondence tabs in Cornerstone and finalize appropriate documents. Cornerstone support can help finalize a group of documents by date if needed.
• If using Unattended End of Day/Month and your practice does an outside backup of your Cornerstone data we suggest navigating to Controls > Defaults > Practice and Workstation > Unattended EOP > Unattended EOD/EOM and unchecking the “Make a copy of the database” feature.  Only turn off the database copy if you confirm you have other backup(s) in place.