Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015
Document Period End Date	Jun. 30, 2016
Cash flows from operating activities:
Net Income (Loss) Attributable to Parent	$ 45,151	$ 37,372
Net Income (Loss) Attributable to Noncontrolling Interest	243	0
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	5,350	5,167
Benefit for deferred taxes	(6,635)	(6,014)
Share based compensation	1,331	839
Provision for doubtful accounts	457	301
Debt discount amortization on convertible debt	0	8
Unrealized foreign exchange gain	(187)	(920)
Capitalized Computer Software, Amortization	654
Reduction of acquisition earnout accruals	(511)	0
Changes in assets and liabilities, net of effects from acquisitions:
Accounts receivable	(6,065)	(3,662)
Other assets	(2,417)	(2,606)
Accounts payable and accrued expenses	(4,189)	(18,802)
Accrued payroll and related benefits	(931)	1,104
Deferred revenue	(1,136)	(2,036)
Deferred rent	(83)	(125)
Unrecognized tax benefits, period increase (decrease)	50	108
Loss Contingency Accrual, Period Increase (Decrease)	0	(690)
Other current liabilities	(106)	111
Net cash provided by operating activities	30,976	10,155
Cash flows from investing activities:
Payments to Develop Software	(694)	0
Purchases of marketable securities	(994)	(704)
Capital expenditures	(2,190)	(10,312)
Net cash used in investing activities	(3,878)	(23,496)
Cash flows from financing activities:
Proceeds from (Repayments of) Lines of Credit	(87,427)	30,000
Proceeds from Issuance of Other Long-term Debt	125,000	0
Repurchases of common stock	(37,657)	(34,481)
Excess tax benefit from share-based compensation	0	63
Proceeds from the exercise of stock options	29	1,117
Forfeiture of certain shares to satisfy exercise costs and the recipients income tax obligations related to stock options exercised and restricted stock vested	(77)	(1,141)
Dividend payments	(4,911)	(5,389)
Principal payments of debt obligations	(600)	(623)
Repayments of Long-term Capital Lease Obligations	0	1
Net cash used in financing activities	(5,643)	(10,455)
Effect of foreign exchange rates on cash	(620)	(1,081)
Net change in cash and cash equivalents	20,835	(24,877)
Cash and cash equivalents at the beginning of the period	57,179	52,300
Cash and cash equivalents at the end of the period	78,014	27,423
Supplemental disclosures of cash flow information:
Interest paid	3,115	2,964
Income taxes paid	10,869	20,926
Via Media Health [Member]
Cash flows from investing activities:
Acquisition of business, net of cash acquired	0	(1,000)
PB Systems [Member]
Cash flows from investing activities:
Acquisition of business, net of cash acquired	$ 0	$ (11,480)