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Fair Value Measurements - Contingent consideration rollforward (Details) - USD ($)
$ in Thousands
3 Months Ended 9 Months Ended
Jan. 02, 2019
Sep. 30, 2019
Jun. 30, 2019
Mar. 31, 2019
Sep. 30, 2018
Sep. 30, 2019
Sep. 30, 2018
Dec. 31, 2018
Change in fair value                
Change in fair value of acquisition-related contingent consideration expense (income)   $ 1,510     $ (8,419) $ 4,516 $ 40,385  
Change in fair value using significant unobservable inputs (Level 3):                
Balance at beginning of period       $ 51,197   51,197    
Acquisition date fair value of contingent consideration           8,720    
Cash consideration paid           (53,542)    
Adjustments to fair value measurement           4,516    
Adjustment to reclassify amounts settled in cash (previously reflected in equity)           609    
Balance at end of period   11,500       11,500    
SinfoniaRx                
Change in fair value                
Change in fair value of acquisition-related contingent consideration expense (income)         $ 8,319 624 $ 40,069  
Contingent consideration               $ 81,692
Contingent consideration equity-classified               39,774
Cash payment for acquisition-related contingent consideration       $ 43,150        
Issuance of common stock (in shares)       614,225        
Value of shares to be issued       $ 39,166        
Peak PACE Solutions                
Change in fair value                
Change in fair value of acquisition-related contingent consideration expense (income)           163    
Cash payment for acquisition-related contingent consideration     $ 1,642          
Contingent consideration liability               1,479
Cognify, Inc                
Change in fair value                
Change in fair value of acquisition-related contingent consideration expense (income)   1,300       3,700    
Contingent consideration liability   11,500       11,500   $ 7,800
DoseMe                
Change in fair value                
Change in fair value of acquisition-related contingent consideration expense (income)   210       $ (30)    
Cash payment for acquisition-related contingent consideration   $ 8,750            
Issuance of common stock (in shares) 149,053