This sounds ideal for a SaaS. Why is each practice messing around with an IT dept and SQL and DR when it could be hosted and managed at low cost for all them at once?
The industry has been really slow to move to SaaS. Avimark's primary competitor has a strong SaaS offering with Idexx Neo [0], but NVA requires the practices they buy to switch to Avimark.
[0] https://www.idexx.com/en/veterinary/software-services/neo/