Segment Information (Details) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2019 USD ($)	Sep. 30, 2019 USD ($)	Jun. 30, 2019 USD ($)	Mar. 31, 2019 USD ($)	Dec. 31, 2018 USD ($)	Sep. 30, 2018 USD ($)	Jun. 30, 2018 USD ($)	Mar. 31, 2018 USD ($)	Dec. 31, 2019 USD ($) segment	Dec. 31, 2018 USD ($)	Dec. 31, 2017 USD ($)
Segment Reporting Information [Line Items]
Number of Reportable Segments | segment									2
Revenue	$ 112,034	$ 111,291	$ 111,803	$ 103,979	$ 103,603	$ 100,013	$ 101,360	$ 94,496	$ 439,107	$ 399,472	$ 286,776
Gross profit	$ 69,917	$ 69,339	$ 70,240	$ 64,778	$ 63,946	$ 62,737	$ 65,755	$ 58,048	274,274	250,486	172,370
Income/(loss) before income taxes									39,728	41,504	(10,396)
Depreciation and amortization									42,976	40,168	28,561
Capital expenditures									30,707	24,637	13,697
Operating Segments | Healthcare
Segment Reporting Information [Line Items]
Revenue									372,014	338,812	234,385
Gross profit									251,114	220,883	153,029
Income/(loss) before income taxes									122,829	98,135	52,054
Depreciation and amortization									34,972	33,119	29,255
Capital expenditures									25,543	20,258	12,542
Operating Segments | Research
Segment Reporting Information [Line Items]
Revenue									54,450	50,561	38,790
Gross profit									20,164	21,603	15,909
Income/(loss) before income taxes									4,653	6,228	1,214
Depreciation and amortization									4,047	3,723	4,148
Capital expenditures									3,591	3,272	1,274
Corporate and Other
Segment Reporting Information [Line Items]
Revenue									12,643	10,099	13,601
Gross profit									2,996	8,000	3,432
Income/(loss) before income taxes									(87,754)	(62,859)	(63,664)
Depreciation and amortization									3,957	3,326	(4,842)
Capital expenditures									$ 1,573	$ 1,107	$ (119)