If you're opening a new optometry practice in the Fraser Valley, the IT line on your budget spreadsheet is probably a placeholder number someone told you at a conference. Here's what it actually breaks down to, based on builds we've priced for single-location clinics with 2–4 exam lanes, a dispensary, and 5–9 workstations.
These numbers are in CAD and assume a standard commercial unit — not a heritage building with plaster walls, which adds cabling cost fast.
The line items
Structured cabling: $2,500–$6,000
Every exam lane, front desk position, and dispensary station needs a wired drop — don't rely on Wi-Fi for anything running your EMR or talking to diagnostic equipment (OCT, fundus camera, auto-refractor). Budget $150–$250 per drop including labor, more if you're pulling cable through finished ceilings or the space wasn't pre-wired by the landlord. A typical 4-lane clinic needs 10–14 drops once you count phones and printers.
Server or server replacement: $0–$8,000
This is the biggest swing item. Cloud-hosted EMR platforms (most newer optometry-specific systems) mean you may not need an on-site server at all — just a solid switch and firewall. If your EMR vendor requires local hosting, or you're keeping an on-prem image archive for OCT/retinal photography, budget $3,500–$8,000 for a proper small-business server with redundant drives. Skip the $500 "basic file server" option — it has no redundancy and it will fail during your busiest month.
Workstations: $900–$1,400 each
Seven stations (2 pretest, 2 exam lanes, front desk, dispensary, office) runs $6,300–$9,800. Don't buy consumer-grade towers — business-class machines (Dell OptiPlex, Lenovo ThinkCentre or equivalent) have better warranties and are easier to image identically, which matters when you're troubleshooting five machines instead of one.
Network hardware — switch, firewall, wireless: $2,500–$5,500
A business firewall with a security subscription (not a $150 consumer router) runs $1,200–$2,800 depending on throughput and how many sites you'll eventually add. A managed PoE switch is $300–$700. Two Wi-Fi 6 access points for guest and staff networks — kept separate from your clinical network — add $250–$600.
Backup and disaster recovery: $1,500–$3,500 setup, $150–$400/month ongoing
This is the line clinics cut first and regret most. You need a backup that's tested, not just scheduled — see our piece on why "scheduled" backups usually aren't working. Budget for local + cloud backup with a defined recovery point objective, not a single external hard drive someone rotates manually.
EMR/imaging integration and go-live support: $1,500–$4,000
Getting your diagnostic devices talking to your EMR (DICOM or proprietary export formats) almost always needs a technician on-site during setup, plus testing time before your first patient day.
Phone system: $800–$2,500
Cloud VoIP for a small clinic is usually $25–$45/line/month with modest setup fees. Skip a legacy on-prem PBX unless you have a specific reason to keep one.
Rough totals
A lean cloud-EMR build for a 4-lane clinic: $16,000–$24,000 one-time, plus $400–$700/month in ongoing support, backup, and subscriptions.
A build with an on-prem server and local imaging archive: $24,000–$38,000 one-time, similar ongoing costs plus server maintenance.
What drives the cost up
Older buildings without existing cabling, EMR vendors that still require on-site servers, more than 2 imaging devices needing integration, and multi-lane builds where every exam room needs redundant drops for future equipment.
What you can safely defer
A second physical server (virtualize instead), enterprise-grade access points if you're under 10 staff, and a full VoIP phone system upgrade if your current lines work — you can swap that in year two. What you should never defer: a real firewall, tested backups, and MFA on every account that touches patient data. Those aren't cost centers, they're the difference between a bad week and a reportable privacy breach.
If you're budgeting a build and want a number specific to your space and equipment list, that's a 20-minute conversation, not a guessing game — we'll walk your floor plan and give you a line-item quote before you sign a lease.