Consolidated Statements of Cash Flow - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Net income	$ 79,533	$ 63,558	$ 59,274
Adjustments to reconcile net income to cash provided by operating activities:
Depreciation and amortization	10,634	9,681	10,107
Provision for doubtful accounts	3,111	1,600	1,147
Provision for deferred taxes, net of acquisitions and effects of currency translation	(10,143)	(1,966)	(10,368)
Unrealized foreign exchange (gain)/losses	(1,743)	(741)	(237)
Unrealized gain on put option	0	(296)	(341)
Share-based compensation	1,821	1,792	1,941
Debt discount amortization on convertible debt	17	35	42
Reduction of acquisition earn-out contingent liability	(1,533)	(10,237)	(10,253)
Changes in current assets and liabilities, net of acquisitions:
Accounts receivable	(7,320)	(1,530)	(3,347)
Other assets	(3,834)	(4,765)	80
Accounts payable and accrued expenses	(19,895)	14,670	1,135
Accrued payroll and related benefits	(60)	1,811	(1,866)
Deferred rent	(656)	(324)	(87)
Reserve for potential uncertain income tax return positions	95	(9,723)	6,817
Liability – securities litigation settlement	(690)	(3,528)	4,226
Other liabilities	1,111	(221)	(225)
Deferred revenue	(1,762)	(1,306)	(983)
Net cash provided by operating activities	48,686	58,510	57,062
Cash flows from investing activities:
investments in joint ventures	(6,000)	0	0
Purchases of marketable securities	(1,435)	0	0
Maturities of marketable securities	0	495	107
Capitalized software development costs	(3,489)	0	0
Capital expenditures	(13,994)	(16,277)	(1,230)
Net cash used in investing activities	(37,393)	(77,786)	(8,840)
Cash flows from financing activities:
Proceeds from / (Repayment) to line of credit, net	86,000	97,625	(15,000)
Principal payments on term loan obligation	(642)	(31,938)	(8,938)
Repurchase of common stock	(81,653)	(31,854)	(2,492)
Payments of long term debt	0	(345)	(665)
Payments for capital lease obligations	(10)	(231)	(277)
Excess Tax Benefit (Provision) From Share Based Compensation, Financing Activities	463	(3,200)	3,237
Proceeds from exercise of common stock options	2,209	788	2,161
Forfeiture of certain shares to satisfy exercise costs and the recipients income tax obligations related to stock options exercised and restricted stock vested	(2,202)	(41)	(1,681)
Shares reacquired in connection with put option	0	(3,535)	0
Dividends paid	(10,472)	(11,406)	(2,794)
Net cash provided (used) by financing activities	(6,307)	15,863	(26,449)
Effect of foreign exchange rates on cash and cash equivalents	(107)	(961)	(1,548)
Net change in cash and cash equivalents	4,879	(4,374)	20,225
Cash and cash equivalents at the beginning of the year	52,300	56,674	36,449
Cash and cash equivalents at the end of the year	57,179	52,300	56,674
Supplemental disclosures of cash flow information:
Interest paid	5,379	1,290	1,169
Income taxes paid	28,637	11,433	13,779
Via Media Health [Member]
Cash flows from investing activities:
Investments in acquired businesses, net of cash acquired	(1,000)	0	0
PB Systems [Member]
Cash flows from investing activities:
Investments in acquired businesses, net of cash acquired	(11,475)	0	0
Curepet, Inc.
Cash flows from investing activities:
Investments in acquired businesses, net of cash acquired	0	3	0
ADAM
Cash flows from investing activities:
Investments in acquired businesses, net of cash acquired	0	(5,856)	0
Vertex
Cash flows from investing activities:
Investments in acquired businesses, net of cash acquired	0	(27,547)	0
Oakstone
Cash flows from investing activities:
Investments in acquired businesses, net of cash acquired	0	(23,791)	0
I3
Cash flows from investing activities:
Investments in acquired businesses, net of cash acquired	0	(2,000)	0
Qatarlyst
Cash flows from investing activities:
Investments in acquired businesses, net of cash acquired	$ 0	$ 0	(4,740)
USIX
Cash flows from investing activities:
Payments of acquisition earn-out contingencies			(727)
Taimma
Cash flows from investing activities:
Payments of acquisition earn-out contingencies	$ 0	$ (2,250)	(2,250)
TriSystems
Cash flows from investing activities:
Payments of acquisition earn-out contingencies	$ 0	$ (563)	$ 0