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Segments and Customer Concentrations - Narrative (Details) - segment
3 Months Ended 9 Months Ended 12 Months Ended
Sep. 30, 2019
Sep. 30, 2018
Sep. 30, 2019
Sep. 30, 2018
Dec. 31, 2018
Segment Reporting Information [Line Items]          
Number of operating segments     1    
Number of reporting segments     1    
Customer Concentration Risk | Revenue | Customer Not Affiliated with Ascension Health          
Segment Reporting Information [Line Items]          
Concentration percentage 15.00% 17.00% 15.00% 13.00%  
Customer Concentration Risk | Revenue | Ascension          
Segment Reporting Information [Line Items]          
Concentration percentage 68.00% 62.00% 67.00% 72.00%  
Customer Concentration Risk | Accounts Receivable | Ascension          
Segment Reporting Information [Line Items]          
Concentration percentage     54.00%   57.00%