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CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($)
shares in Thousands, $ in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Revenues:      
Revenues: $ 339,435 $ 326,648 $ 280,629
Costs of revenue (exclusive of amortization and depreciation):      
Total costs of revenue (exclusive of amortization and depreciation) 175,868 166,541 135,781
Product development 37,246 31,898 32,809
Sales and marketing 28,049 27,131 21,978
General and administrative 76,153 54,965 48,481
Amortization 24,522 20,887 14,717
Depreciation 1,946 2,443 2,156
Goodwill impairment 35,913 0 0
Trademark impairment 2,342 0 0
Total expenses 382,039 303,865 255,922
Operating income (loss) (42,604) 22,783 24,707
Other income (expense):      
Other income 745 1,178 1,529
Gain on contingent consideration 0 565 0
Loss on extinguishment of debt 0 (125) 0
Interest expense (12,521) (6,320) (3,160)
Total other income (expense) (11,776) (4,702) (1,631)
Income (loss) before taxes (54,380) 18,081 23,076
Provision (benefit) for income taxes (8,591) 2,214 4,646
Net income (loss) $ (45,789) $ 15,867 $ 18,430
Net income (loss) per share - basic (in dollars per share) $ (3.15) $ 1.08 $ 1.26
Net income (loss) per share - diluted (in dollars per share) $ (3.15) $ 1.08 $ 1.26
Weighted average shares outstanding used in per common share computations:      
Basic (in shares) 14,187 14,356 14,290
Diluted (in shares) 14,187 14,356 14,318
RCM      
Revenues:      
Revenues: $ 193,929 $ 179,870 $ 131,242
Costs of revenue (exclusive of amortization and depreciation):      
Total costs of revenue (exclusive of amortization and depreciation) 110,192 97,024 66,015
EHR      
Revenues:      
Revenues: 138,063 139,823 143,109
Costs of revenue (exclusive of amortization and depreciation):      
Total costs of revenue (exclusive of amortization and depreciation) 62,048 65,661 66,698
Patient engagement      
Revenues:      
Revenues: 7,443 6,955 6,278
Costs of revenue (exclusive of amortization and depreciation):      
Total costs of revenue (exclusive of amortization and depreciation) $ 3,628 $ 3,856 $ 3,068