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Consolidated Statements of Operations - USD ($)
shares in Thousands, $ in Thousands
 12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Sales revenues:      
Sales revenues: $ 326,648 $ 280,629 $ 264,488
Costs of sales (exclusive of amortization shown separately below):      
Total costs of sales 172,213 139,747 128,242
Gross profit 154,435 140,882 136,246
Operating expenses:      
Product development 30,926 30,389 33,457
Sales and marketing 27,131 21,978 22,835
General and administrative 56,192 50,022 47,479
Amortization of acquisition-related intangibles 17,403 13,786 11,421
Total operating expenses 131,652 116,175 115,192
Operating income 22,783 24,707 21,054
Other income (expense):      
Other income 1,178 1,529 1,494
Gain on contingent consideration 565 0 0
Loss on extinguishment of debt (125) 0 (202)
Interest expense (6,320) (3,160) (3,562)
Total other income (expense) (4,702) (1,631) (2,270)
Income before taxes 18,081 23,076 18,784
Provision for income taxes 2,214 4,646 4,538
Net income $ 15,867 $ 18,430 $ 14,246
Net income (loss) per share - basic (in dollars per share) $ 1.08 $ 1.26 $ 0.98
Net income (loss) per share - diluted (in dollars per share) $ 1.08 $ 1.26 $ 0.98
Weighted average shares outstanding used in per common share computations:      
Basic (in shares) 14,356 14,290 14,038
Diluted (in shares) 14,356 14,318 14,038
Revenue cycle      
Sales revenues:      
Sales revenues: $ 179,870 $ 131,242 $ 107,431
Costs of sales (exclusive of amortization shown separately below):      
Total costs of sales 97,010 66,015 57,461
Electronic health record      
Sales revenues:      
Sales revenues: 139,823 143,109 152,954
Costs of sales (exclusive of amortization shown separately below):      
Total costs of sales 71,347 70,664 69,361
Patient engagement      
Sales revenues:      
Sales revenues: 6,955 6,278 4,103
Costs of sales (exclusive of amortization shown separately below):      
Total costs of sales $ 3,856 $ 3,068 $ 1,420