Annual report pursuant to Section 13 and 15(d)

Commitments and Contingencies - Additional Information (Details)

v3.10.0.1
Commitments and Contingencies - Additional Information (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2018
Dec. 31, 2017
Dec. 31, 2016
Commitments And Contingencies [Line Items]      
Rent expense $ 1,638 $ 1,148 $ 1,028
Outstanding purchase orders with its outside vendors and suppliers 61,000    
MedSupport Systems B.V.      
Commitments And Contingencies [Line Items]      
Rent expense $ 33 $ 21  
Offices and Certain Equipment      
Commitments And Contingencies [Line Items]      
Operating leases expiration date Sep. 30, 2024