Business Combinations MedTouch (Details) - USD ($) $ in Thousands		3 Months Ended		9 Months Ended
	Jan. 06, 2020	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Business Acquisition [Line Items]
Adjustment to fair value of contingent consideration		$ 2,061	$ (2)	$ 3,793	$ (310)
Goodwill		419,029		419,029		$ 335,564
MedTouch
Business Acquisition [Line Items]
Date of acquisition	Jan. 06, 2020
Total purchase price	$ 20,000
Cash paid for acquisition	13,900
Common stock issued	1,900
Initial fair value estimate of additional earnings-based contingent consideration	4,200
Contingent consideration, maximum cash payout	10,200
Fair value of contingent consideration		8,200		8,200
Adjustment to fair value of contingent consideration		$ 2,000		$ 4,000
Transaction costs	600
Acquired tangible assets	4,700
Identified intangible assets	6,700
Liabilities assumed	(6,000)
Goodwill	14,600
Tax deductible amount of Goodwill	$ 11,200