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Business Combinations, Goodwill and Intangible Assets - Additional Information - SCIO (Details) - USD ($) $ in Thousands		3 Months Ended
	Jul. 01, 2018	Mar. 31, 2019	Mar. 31, 2018
SCIO
Business Acquisition [Line Items]
Purchase consideration	$ 245,044
Trade names and trademarks \| SCIO
Business Acquisition [Line Items]
Weighted average useful life	3 years
Developed technology \| SCIO
Business Acquisition [Line Items]
Weighted average useful life	5 years
Customer relationships \| SCIO
Business Acquisition [Line Items]
Weighted average useful life	10 years
Restricted Stock \| SCIO
Business Acquisition [Line Items]
Stock issued during period (in shares)	69,459
Restricted common stock issued for acquisition of SCIO	$ 4,080
Minimum \| SCIO
Business Acquisition [Line Items]
Purchase consideration	236,500
Revolving Credit Facility \| SCIO
Business Acquisition [Line Items]
Utilized revolver credit facility to finance acquisition	$ 233,000
General and administrative expenses \| SCIO and Health Integrated
Business Acquisition [Line Items]
Acquisition related costs		$ 0	$ 363