Business Combinations - Additional Information (Detail) (USD $)				0 Months Ended				12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Sep. 09, 2013 Baptist Leadership Group [Member]	Dec. 31, 2013 Decision Critical, Inc. [Member]	Jun. 29, 2012 Decision Critical, Inc. [Member]	Oct. 19, 2012 Sy. Med Development, Inc. [Member]	Dec. 31, 2013 Sy. Med Development, Inc. [Member]
Business Acquisition [Line Items]
Acquisition date of assets				Sep. 09, 2013		Jun. 29, 2012		Oct. 19, 2012
Consideration paid for acquisition in cash				$ 7,400,000		$ 3,400,000	$ 7,400,000
Consideration paid for acquisition in shares				15,230		22,124	34,060
Additional consideration paid for acquisition in cash						300,000	1,500,000
Contingent upon achievement of certain financial targets and business outcome, term						3 years	2 years
Contingent payments have been paid to the DCI shareholders					146,000			625,000
Transaction costs associated with the DCI acquisition				145,000		203,000		165,000
Purchase price allocation for goodwill	35,746,000	29,299,000	21,147,000	6,300,000		2,900,000		5,400,000
Purchase price allocation for identifiable intangible assets				1,600,000		1,500,000		6,500,000
Purchase price allocation for net tangible assets				28,000		291,000		294,000
Purchase price allocation for deferred tax liabilities						456,000		2,800,000
Net tangible assets include deferred revenue book value				508,000		548,000		1,100,000
Net tangible assets include deferred revenue estimated fair value				254,000		356,000		229,000
Write-down of deferred revenue				$ 254,000		$ 192,000		$ 916,000