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Equity method investments (Details) - USD ($)
$ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2020
Sep. 30, 2019
Sep. 30, 2020
Sep. 30, 2019
Jul. 24, 2020
Dec. 31, 2019
Equity Method Investments and Joint Ventures [Abstract]            
Oncacare Limited $ 4,817   $ 4,817   $ 4,900 $ 0
Equity method investment, ownership percentage (percentage) 49.00%   49.00%      
Equity method investment, majority ownership percentage (percentage) 51.00%   51.00%      
Equity method investment, period majority voting share capital can be sold to the company     18 months      
Payments to Acquire Equity Method Investments     $ 2,450 $ 0    
Loss on equity method investments $ 83 $ 0 $ 83 $ 0