Accounts Payable and Accrued Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Schedule of accounts payable and accrued liabilities
Salary and payroll tax accrual	$ 13,393	$ 9,449
Taxes payable	3,437	2,655
License fee obligation	1,000	1,000
Placement fees payable	2,490	4,000
Accrued other	6,339	7,850
Total accrued liabilities	$ 26,659	$ 24,954