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Business combinations - Schedule of Acquisitions, MedPass Group Acquisition (Details) - USD ($) |  | 12 Months Ended |
--- | --- | --- | ---
Jan. 22, 2020 | Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | Jan. 31, 2021
Business Acquisition [Line Items] |  |  |  |  |
Goodwill |  | $ 9,037,931,000 | $ 936,257,000 | $ 883,170,000 |
Fair value of cash consideration |  | $ 5,914,475,000 | $ 47,931,000 | $ 131,272,000 |
Medpass Group Limited |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |
Cash and cash equivalents | $ 10,170,000 |  |  |  |
Property, plant and equipment | 45,000 |  |  |  |
Operating right of use assets | 539,000 |  |  |  |
Goodwill | 27,191,000 |  |  |  |
Accounts receivable | 3,033,000 |  |  |  |
Prepayments and other current assets | 158,000 |  |  |  |
Accounts payable | (368,000) |  |  |  |
Unearned revenue | (989,000) |  |  |  |
Other liabilities | (2,202,000) |  |  |  |
Current lease liabilities | (219,000) |  |  |  |
Non-current portion of operating lease liabilities | (320,000) |  |  |  |
Deferred tax liabilities | (4,090,000) |  |  |  |
Net assets acquired | 47,556,000 |  |  |  |
Fair value of cash consideration | 46,992,000 |  |  |  |
Working capital adjustment paid | (564,000) |  |  |  |
Contingent consideration | 0 |  |  |  | $ 0
Total consideration | 47,556,000 |  |  |  |
Goodwill, expected tax deductible amount | 0 |  |  |  |
Contingent consideration, range of outcomes, maximum value | 6,700,000 |  |  |  |
Medpass Group Limited | Customer relationships |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |
Intangible assets | 11,725,000 |  |  |  |
Medpass Group Limited | Order backlog |  |  |  |  |
Business Acquisition [Line Items] |  |  |  |  |
Intangible assets | $ 2,883,000 |  |  |  |

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