Quarterly report pursuant to Section 13 or 15(d)

Leases - Additional Information (Details)

v3.19.1
Leases - Additional Information (Details) - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2019
Jan. 01, 2019
Lessee Lease Description [Line Items]    
Operating lease, option to extend options to extend the leases for up to 5 years.  
Operating lease, existence of option to extend [true false] true  
Operating lease right-of-use asset $ 5,936 $ 6,418
Operating lease, liability 6,981 $ 6,418
Operating lease cost 544  
MedSupport Systems B.V.    
Lessee Lease Description [Line Items]    
Operating lease cost $ 8  
Minimum    
Lessee Lease Description [Line Items]    
Operating leases, lease term 2 years  
Maximum    
Lessee Lease Description [Line Items]    
Operating leases, lease term 8 years  
Operating lease option to extend term 5 years