Revenue Recognition and Contractual Adjustments - Contract Assets and Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Contract with Customer, Asset, Net [Abstract]
Current pharma contract assets	$ 234	$ 86
Long-term pharma contract assets	627	268
Total pharma contract assets	861	354
Capitalized Contract Cost [Abstract]
Current pharma capitalized commissions	222	271
Long-term pharma capitalized commissions	839	650
Total pharma capitalized commissions	1,061	921
Contract with Customer, Liability [Abstract]
Current pharma contract liabilities	1,187	927
Long-term pharma contract liabilities	1,898	1,652
Total pharma contract liabilities	$ 3,085	$ 2,579

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