Health Catalyst (HCAT) 10-Q 10 Nov 20 2020 Q3 Quarterly report Financial data

Cover Page

Cover Page - shares	9 Months Ended
	Sep. 30, 2020	Oct. 31, 2020
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2020
Document Transition Report	false
Entity File Number	001-38993
Entity Registrant Name	HEALTH CATALYST, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	45-3337483
Entity Address, Address Line One	3165 Millrock Drive #400
Entity Address, City or Town	Salt Lake City
Entity Address, State or Province	UT
Entity Address, Postal Zip Code	84121
City Area Code	801
Local Phone Number	708-6800
Title of 12(b) Security	Common Stock, par value $0.001 per share
Trading Symbol	HCAT
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	true
Entity Ex Transition Period	true
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		42,498,469
Entity Central Index Key	0001636422
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q3
Amendment Flag	false

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands		Sep. 30, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents		$ 111,239	$ 18,032
Short-term investments		163,898	210,245
Accounts receivable, net	[1]	36,339	27,570
Prepaid expenses and other assets		11,290	8,392
Total current assets		322,766	264,239
Property and equipment, net		5,319	4,295
Intangible assets, net		105,926	25,535
Operating lease right-of-use assets		25,833	3,787
Goodwill		107,822	3,694
Other assets		2,997	810
Total assets		570,663	302,360
Current liabilities:
Accounts payable		5,189	3,622
Accrued liabilities		14,061	8,944
Acquisition-related consideration payable	[1]	3,214	2,192
Deferred revenue	[1]	35,090	30,653
Operating lease liabilities		2,425	2,806
Contingent consideration liabilities		5,893	0
Total current liabilities		65,872	48,217
Long-term debt		166,200	48,200
Acquisition-related consideration payable, net of current portion	[1]	0	1,860
Deferred revenue, net of current portion		1,635	1,459
Operating lease liabilities, net of current portion		24,245	1,654
Contingent consideration liabilities, net of current portion		10,279	0
Other liabilities		2,817	326
Total liabilities		271,048	101,716
Commitments and contingencies (Note 14)
Stockholders’ equity:
Preferred stock, $0.001 par value per share; 25,000,000 shares authorized and no shares issued and outstanding as of as of September 30, 2020 and December 31, 2019		0	0
Common stock, $0.001 par value per share; 500,000,000 shares authorized as of September 30, 2020 and December 31, 2019; 42,239,922 and 36,678,854 shares issued and outstanding as of September 30, 2020 and December 31, 2019, respectively		42	37
Additional paid-in capital		982,139	811,049
Accumulated deficit		(682,632)	(610,514)
Accumulated other comprehensive income		66	72
Total stockholders’ equity		299,615	200,644
Total liabilities and stockholders’ equity		$ 570,663	$ 302,360
[1]	Includes amounts attributable to related party transactions. See Note 16 for further details.

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 2020	Dec. 31, 2019
Statement of Financial Position [Abstract]
Preferred stock, par value (in dollars per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)	25,000,000	25,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	500,000,000	500,000,000
Common stock, shares issued (in shares)	42,239,922	36,678,854
Common stock, shares outstanding (in shares)	42,239,922	36,678,854

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations - USD ($) $ in Thousands		3 Months Ended		9 Months Ended
		Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Revenue:
Revenue	[1]	$ 47,191	$ 39,423	$ 135,566	$ 111,440
Cost of revenue, excluding depreciation and amortization:
Total cost of revenue, excluding depreciation and amortization		24,352	18,632	71,549	53,668
Operating expenses:
Sales and marketing		14,629	14,721	40,618	35,579
Research and development		13,390	13,477	38,539	33,209
General and administrative		13,297	11,013	31,111	23,333
Depreciation and amortization		4,981	2,316	10,952	6,844
Total operating expenses		46,297	41,527	121,220	98,965
Loss from operations		(23,458)	(20,736)	(57,203)	(41,193)
Loss on extinguishment of debt		0	0	(8,514)	(1,670)
Interest and other expense, net		(3,854)	(659)	(7,500)	(2,924)
Loss before income taxes		(27,312)	(21,395)	(73,217)	(45,787)
Income tax (benefit) provision		14	21	(1,218)	43
Net loss		(27,326)	(21,416)	(71,999)	(45,830)
Less: accretion of redeemable convertible preferred stock		0	18,170	0	180,826
Net loss attributable to common stockholders		$ (27,326)	$ (39,586)	$ (71,999)	$ (226,656)
Net loss per share attributable to common stockholders, basic and diluted (in dollars per share)		$ (0.68)	$ (1.40)	$ (1.87)	$ (17.78)
Weighted-average shares outstanding used in calculating net loss per share attributable to common stockholders, basic and diluted (in shares)		40,292,380	28,222,555	38,517,272	12,749,903
Technology
Revenue:
Revenue	[1]	$ 27,964	$ 21,160	$ 78,150	$ 61,393
Cost of revenue, excluding depreciation and amortization:
Total cost of revenue, excluding depreciation and amortization		9,045	6,740	25,148	20,536
Professional services
Revenue:
Revenue	[1]	19,227	18,263	57,416	50,047
Cost of revenue, excluding depreciation and amortization:
Total cost of revenue, excluding depreciation and amortization		$ 15,307	$ 11,892	$ 46,401	$ 33,132
[1]	Includes amounts attributable to related party transactions. See Note 16 for further details.

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive Loss - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Statement of Comprehensive Income [Abstract]
Net Loss	$ (27,326)	$ (21,416)	$ (71,999)	$ (45,830)
Other comprehensive income (loss):
Change in unrealized gain on investments	(128)	(21)	(18)	(11)
Change in foreign currency translation adjustment	19	0	12
Comprehensive loss	$ (27,435)	$ (21,437)	$ (72,005)	$ (45,841)

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Redeemable Convertible Preferred Stock and Stockholders' Equity (Deficit) - USD ($) $ in Thousands	Total	Adoption of the current expected credit loss standard	IPO	Common Stock	Common StockIPO	Additional Paid-In Capital	Additional Paid-In CapitalIPO	Accumulated Deficit	Accumulated DeficitAdoption of the current expected credit loss standard	Accumulated Other Comprehensive Income (Loss)
Beginning balance (in shares) at Dec. 31, 2018	22,713,694
Beginning balance at Dec. 31, 2018	$ 409,845
Preferred Stock
Issuance of Series F redeemable convertible preferred stock, net of issuance costs of $115 (in shares)	437,787
Issuance of Series F redeemable convertible preferred stock, net of issuance costs of $115	$ 12,073
Accretion of redeemable convertible preferred stock	$ 180,826
Conversion of redeemable convertible preferred stock (in shares)	(23,151,481)
Conversion of redeemable convertible preferred stock	$ (602,744)
Ending balance (in shares) at Sep. 30, 2019	0
Ending balance at Sep. 30, 2019	$ 0
Beginning balance (in shares) at Dec. 31, 2018				4,779,356
Beginning balance at Dec. 31, 2018	(374,768)			$ 5		$ 0		$ (374,772)		$ (1)
Common Stock
Exercise of stock options (in shares)				301,427
Exercise of stock options	2,177					2,177
Stock-based compensation	13,028					13,028
Accretion of redeemable convertible preferred stock	(180,826)					(5,180)		(175,646)
Conversion of redeemable convertible preferred stock (in shares)				23,151,481
Conversion of redeemable convertible preferred stock	602,744			$ 23		602,721
Initial public offering, net of underwriters’ discounts, commissions, and offering costs (in shares)					8,050,000
Initial public offering, net of underwriters’ discounts, commissions, and offering costs			$ 190,039		$ 8		$ 190,031
Exercise of common stock warrants (in shares)				189,959
Net loss	(45,830)							(45,830)
Other comprehensive loss	(11)									(11)
Ending balance (in shares) at Sep. 30, 2019				36,472,223
Ending balance at Sep. 30, 2019	$ 206,553			$ 36		802,777		(596,248)		(12)
Beginning balance (in shares) at Dec. 31, 2018	22,713,694
Beginning balance at Dec. 31, 2018	$ 409,845
Ending balance (in shares) at Dec. 31, 2019	0
Ending balance at Dec. 31, 2019	$ 0
Beginning balance (in shares) at Dec. 31, 2018				4,779,356
Beginning balance at Dec. 31, 2018	$ (374,768)			$ 5		0		(374,772)		(1)
Ending balance (in shares) at Dec. 31, 2019	36,731,632			36,678,854
Ending balance at Dec. 31, 2019	$ 200,644	$ (119)		$ 37		811,049		(610,514)	$ (119)	72
Common Stock
Accounting Standards Update [Extensible List]	us-gaap:AccountingStandardsUpdate201613Member
Beginning balance (in shares) at Jun. 30, 2019	23,151,481
Beginning balance at Jun. 30, 2019	$ 584,574
Preferred Stock
Accretion of redeemable convertible preferred stock	$ 18,170
Conversion of redeemable convertible preferred stock (in shares)	(23,151,481)
Conversion of redeemable convertible preferred stock	$ (602,744)
Ending balance (in shares) at Sep. 30, 2019	0
Ending balance at Sep. 30, 2019	$ 0
Beginning balance (in shares) at Jun. 30, 2019				5,002,426
Beginning balance at Jun. 30, 2019	(557,149)			$ 5		0		(557,163)		9
Common Stock
Exercise of stock options (in shares)				78,357
Exercise of stock options	552					552
Stock-based compensation	9,974					9,974
Accretion of redeemable convertible preferred stock	(18,170)					(501)		(17,669)
Conversion of redeemable convertible preferred stock (in shares)				23,151,481
Conversion of redeemable convertible preferred stock	602,744			$ 23		602,721
Initial public offering, net of underwriters’ discounts, commissions, and offering costs (in shares)					8,050,000
Initial public offering, net of underwriters’ discounts, commissions, and offering costs			$ 190,039		$ 8		$ 190,031
Exercise of common stock warrants (in shares)				189,959
Net loss	(21,416)							(21,416)
Other comprehensive loss	(21)									(21)
Ending balance (in shares) at Sep. 30, 2019				36,472,223
Ending balance at Sep. 30, 2019	$ 206,553			$ 36		802,777		(596,248)		(12)
Beginning balance (in shares) at Dec. 31, 2019	0
Beginning balance at Dec. 31, 2019	$ 0
Ending balance (in shares) at Sep. 30, 2020	0
Ending balance at Sep. 30, 2020	$ 0
Beginning balance (in shares) at Dec. 31, 2019	36,731,632			36,678,854
Beginning balance at Dec. 31, 2019	$ 200,644	$ (119)		$ 37		811,049		(610,514)	$ (119)	72
Common Stock
Issuance of common stock for acquisition consideration (in shares)				2,190,229
Issuance of common stock as consideration for acquisitions	72,457			$ 2		72,455
Equity component of convertible senior notes, net of issuance costs	61,213					61,213
Purchase of Capped Calls concurrent with issuance of convertible senior notes	(21,743)
Issuance of common stock under employee stock purchase plan (in shares)				97,113
Issuance of common stock under employee stock purchase plan	$ 2,408					2,408
Vesting of restricted stock units and restricted shares (in shares)				157,333
Exercise of stock options (in shares)	3,116,393			3,116,393
Exercise of stock options	$ 29,393			$ 3		29,390
Stock-based compensation	27,367					27,367
Accretion of redeemable convertible preferred stock	0
Net loss	(71,999)							(71,999)
Other comprehensive loss	$ (6)									(6)
Ending balance (in shares) at Sep. 30, 2020	42,239,922			42,239,922
Ending balance at Sep. 30, 2020	$ 299,615			$ 42		982,139		(682,632)		66
Beginning balance (in shares) at Jun. 30, 2020	0
Beginning balance at Jun. 30, 2020	$ 0
Ending balance (in shares) at Sep. 30, 2020	0
Ending balance at Sep. 30, 2020	$ 0
Beginning balance (in shares) at Jun. 30, 2020				38,729,662
Beginning balance at Jun. 30, 2020	233,962			$ 39		889,054		(655,306)		175
Common Stock
Issuance of common stock for acquisition consideration (in shares)				2,079,567
Issuance of common stock as consideration for acquisitions	69,125			$ 2		69,123
Vesting of restricted stock units and restricted shares (in shares)				82,641
Exercise of stock options (in shares)				1,348,052
Exercise of stock options	14,383			$ 1		14,382
Stock-based compensation	9,580					9,580
Net loss	(27,326)							(27,326)
Other comprehensive loss	$ (109)									(109)
Ending balance (in shares) at Sep. 30, 2020	42,239,922			42,239,922
Ending balance at Sep. 30, 2020	$ 299,615			$ 42		$ 982,139		$ (682,632)		$ 66

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Redeemable Convertible Preferred Stock and Stockholders' Equity (Deficit) (Parenthetical) $ in Thousands	9 Months Ended
	Sep. 30, 2019USD ($)
Issuance costs	$ 4,407
Conversion of redeemable convertible preferred stock	602,744
Shares of redeemable convertible preferred stock
Issuance costs	$ 115

Condensed Consolidated Statem_5

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Cash flows from operating activities
Net loss	$ (71,999)	$ (45,830)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	10,952	6,844
Loss on extinguishment of debt	8,514	1,670
Amortization of debt discount and issuance costs	5,260	797
Non-cash operating lease expense	2,865	2,696
Investment discount and premium amortization	854	(443)
Provision for expected credit losses	822	0
Stock-based compensation expense	27,283	13,028
Deferred tax benefit	(1,280)	0
Change in fair value of contingent consideration liabilities	(1,004)	0
Other	85	(36)
Change in operating assets and liabilities:
Accounts receivable, net	(4,450)	(3,323)
Prepaid expenses and other assets	(2,937)	(1,362)
Accounts payable, accrued liabilities, and other liabilities	6,567	1,661
Deferred revenue	(838)	7,601
Operating lease liabilities	(2,701)	(2,426)
Net cash used in operating activities	(22,007)	(19,123)
Cash flows from investing activities
Purchase of short-term investments	(163,346)	(221,444)
Proceeds from the sale and maturity of short-term investments	208,467	37,277
Acquisition of businesses, net of cash acquired	(102,471)	0
Purchases of property and equipment	(2,071)	(1,658)
Purchase of intangible assets	(1,249)	(1,747)
Proceeds from the sale of property and equipment	10	40
Net cash used in investing activities	(60,660)	(187,532)
Cash flows from financing activities
Proceeds from convertible senior notes, net of issuance costs	222,482	0
Purchase of capped calls concurrent with issuance of convertible senior notes	(21,743)	0
Proceeds from credit facilities, net of debt issuance costs	0	47,169
Repayment of credit facilities	(57,043)	(21,821)
Proceeds from initial public offering, net of underwriters’ discounts and commissions	0	194,649
Proceeds from the issuance of redeemable convertible preferred stock, net of issuance costs	0	12,073
Proceeds from exercise of stock options	29,393	2,177
Proceeds from employee stock purchase plan	3,528	1,216
Payments of acquisition-related consideration	(748)	(773)
Payments of deferred offering costs	0	(4,407)
Net cash provided by financing activities	175,869	230,283
Effect of exchange rate changes	5	0
Net increase in cash and cash equivalents	93,207	23,628
Cash and cash equivalents at beginning of period	18,032	28,431
Cash and cash equivalents at end of period	111,239	52,059
Supplemental disclosures of non-cash investing and financing information
Redeemable convertible preferred stock accretion	0	180,826
Deferred offering costs included in accounts payable and accrued liabilities	0	203
Purchase of intangible assets included in accounts payable and accrued liabilities	0	1,304
Purchase of property and equipment included in accounts payable and accrued liabilities	1,364	155
Operating lease right-of-use assets obtained in exchange for operating lease obligations	$ 24,456	$ 581

Description of Business and Sum

Description of Business and Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
Description of Business and Summary of Significant Accounting Policies	Description of Business and Summary of Significant Accounting Policies Nature of operations Health Catalyst, Inc. (Health Catalyst) was incorporated under the laws of Delaware in September 2011. We are a leading provider of data and analytics technology and services to healthcare organizations. Our Solution comprises a cloud-based data platform, analytics software, and professional services expertise. Our customers, which are primarily healthcare providers, use our Solution to manage their data, derive analytical insights to operate their organization, and produce measurable clinical, financial, and operational improvements. Basis of presentation Our accompanying unaudited condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States (GAAP) and the applicable regulations of the U.S. Securities and Exchange Commission (SEC) regarding interim financial reporting. Certain information and note disclosures normally included in annual financial statements prepared in accordance with GAAP have been condensed or omitted. Therefore, these unaudited condensed consolidated financial statements should be read in conjunction with our audited consolidated financial statements and the related notes thereto as of and for the year ended December 31, 2019 included in our Annual Report on Form 10-K. Reclassifications Certain prior year amounts on the condensed consolidated statements of cash flows have been reclassified to conform to the current year presentation. A reclassification was made to separately present the non-cash operating lease expense as a non-cash reconciling adjustment from net loss and the change in the operating lease liabilities due to cash payments as a change in operating assets and liabilities. This net change is not material and does not affect previously reported net cash used in operating activities in the condensed consolidated statements of cash flows. This reclassification had no effect on our other condensed consolidated financial statements for the nine months ended September 30, 2020 and 2019. Interim Unaudited Condensed Consolidated Financial Statements Our accompanying interim condensed consolidated balance sheet as of September 30, 2020, the interim condensed consolidated statements of operations for the three and nine months ended September 30, 2020 and 2019, our interim condensed consolidated statements of redeemable convertible preferred stock and stockholders' equity (deficit) for the three and nine months ended September 30, 2020 and 2019, and our interim condensed consolidated statements of cash flows for the nine months ended September 30, 2020 and 2019 are unaudited. Our condensed consolidated balance sheet as of December 31, 2019 was derived from audited financial statements, but does not include all disclosures required by GAAP. Our interim unaudited condensed consolidated financial statements have been prepared on a basis consistent with our annual consolidated financial statements and, in the opinion of management, reflect all adjustments, which include only normal recurring adjustments, necessary to state fairly the Company's financial position, its operations and cash flows for the periods presented. The historical results are not necessarily indicative of future results, and the results of operations for the three and nine months ended September 30, 2020 are not necessarily indicative of the results to be expected for the full year or any other period. Initial Public Offering On July 29, 2019, we closed our initial public offering of common stock (IPO) in which we issued and sold 8,050,000 shares (inclusive of the underwriters’ over-allotment option to purchase 1,050,000 shares, which was exercised on July 25, 2019) of common stock at $26.00 per share. We received net proceeds of $194.6 million after deducting underwriting discounts and commissions and before deducting offering costs of $4.6 million. Upon the closing of our IPO, all shares of our outstanding redeemable convertible preferred stock converted into 23,151,481 shares of common stock on a one-for-one basis. Stock Split On July 10, 2019, we effected a 1-for-2 reverse stock split of our capital stock. We have adjusted all references to share and per share amounts in the accompanying condensed consolidated financial statements and notes to reflect the reverse stock split. Principles of consolidation Our condensed consolidated financial statements include the accounts of Health Catalyst and its wholly-owned subsidiaries. Intercompany balances and transactions have been eliminated. Use of estimates The preparation of financial statements in conformity with accounting principles generally accepted in the United States requires us to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. On an on-going basis, we evaluate our estimates, including those related to revenue recognition, provisions for expected credit losses, useful lives of property and equipment, capitalization and estimated useful life of internal-use software and other intangible assets, fair value of financial instruments, deferred tax assets, stock-based compensation, contingent consideration, the period of benefit for deferred contract acquisition costs, the incremental borrowing rate used for operating leases, and tax uncertainties. Actual results could differ from those estimates. Segment reporting Operating segments are identified as components of an enterprise about which separate discrete financial information is evaluated by the chief operating decision maker (the CODM) in assessing performance and making decisions regarding resource allocation. We operate our business in two operating segments that also represent our reportable segments. Our segments are (1) technology and (2) professional services. The CODM uses Adjusted Gross Profit (defined as revenue less cost of revenue that excludes depreciation, amortization, stock-based compensation expense, and certain other operating expenses) as the measure of our profit. Net loss per share Basic net loss per share is calculated by dividing net loss attributable to common stockholders by the weighted average number of shares of common stock outstanding. Net loss attributable to common stockholders is computed as net loss less accretion of redeemable convertible preferred stock. Diluted net loss per share attributable to common stockholders is calculated by giving effect to all potentially dilutive common stock equivalents outstanding for the period. For purposes of this calculation, stock options, restricted stock units (RSUs), restricted shares, and purchase rights committed under the employee stock purchase plan are considered to be common stock equivalents but have been excluded from the calculation of diluted net loss per share attributable to common stockholders as the effect is antidilutive. Since we have the intent and ability to settle the principal amount of our convertible senior notes in cash and any excess in shares of our common stock, we use the treasury stock method for calculating any potential dilutive effect of the conversion spread on net income (loss) per share, if applicable. The conversion spread has a potentially dilutive impact when the average market price of our common stock for a given period exceeds $30.60 per share. The capped calls are excluded from the calculation of diluted earnings per share, as they would be antidilutive under the treasury stock method. Prior to our IPO, we computed basic and diluted net loss per share in conformity with the two-class method required for participating securities. The two-class method is an earnings allocation formula that treats a participating security as having rights to earnings that otherwise would have been available to holders of common stock. Redeemable convertible preferred stock and common stock were considered participating securities for purposes of this calculation. However, the two-class method did not impact the net loss per common share attributable to common stockholders as we were in a loss position for each of the periods presented and the redeemable convertible preferred stockholders did not have a contractual obligation to participate in losses. Revenue recognition We recognize revenue in accordance with Accounting Standards Codification Topic 606, Revenue from Contracts with Customers (Topic 606) . We derive our revenues primarily from technology subscriptions and professional services. We determine revenue recognition by applying the following steps: • Identification of the contract, or contracts, with a customer; • Identification of the performance obligations in the contract; • Determination of the transaction price; • Allocation of the transaction price to the performance obligations in the contract; and • Recognition of revenue when, or as, we satisfy the performance obligation. We recognize revenue net of any taxes collected from customers and subsequently remitted to governmental authorities. Technology revenue Technology revenue primarily consists of subscription fees charged to customers for access to use our technology. We provide customers access to our technology through either an all-access or limited-access, modular subscription. The majority of our subscription arrangements are cloud-based and do not provide customers the right to take possession of the technology or contain a significant penalty if the customer were to take possession of the technology. Revenue from cloud-based subscriptions is recognized ratably over the contract term beginning on the date that the service is made available to the customer. Most of our DOS subscription contracts have up to a three-year term, of which the vast majority are terminable after one year upon 90 days’ notice. Subscriptions that allow the customer to take software on-premise without significant penalty are treated as time-based licenses. These arrangements generally include access to technology, access to unspecified future products, and maintenance and support. Revenue for upfront access to our technology library is recognized at a point in time when the technology is made available to the customer. Revenue for access to unspecified future products included in time-based license subscriptions is recognized ratably over the contract term beginning on the date that the access is made available to the customer. We also have certain perpetual license arrangements. Revenue from these arrangements is recognized at a point in time upon delivery of the software. Technology revenue also includes maintenance and support revenue which generally includes bug fixes, updates, and support services. Revenue related to maintenance and support is recognized over the contract term beginning on the date that the service is made available to the customer. Professional services revenue Professional services revenue primarily includes data and analytics services, domain expertise services, outsourcing services, and implementation services. Professional services arrangements typically include a fee for making full-time equivalent (FTE) services available to our customers on a monthly basis. FTE services generally consist of a blend of analytic engineers, analysts, and data scientists based on the domain expertise needed to best serve our customer. Professional services are typically considered distinct from the technology offerings and revenue is generally recognized as the service is provided using the “right to invoice” practical expedient. Contracts with multiple performance obligations Many of our contracts include multiple performance obligations. We account for performance obligations separately if they are capable of being distinct within the context of the contract. In these circumstances, the transaction price is allocated to separate performance obligations on a relative standalone selling price basis. We determine standalone selling prices based on the observable price a good or service is sold for separately when available. In cases where standalone selling prices are not directly observable, based on information available, we utilize the expected cost plus a margin, adjusted market assessment, or residual estimation method. We consider all information available including our overall pricing objectives, market conditions, and other factors, which may include customer demographics and the types of users. Standalone selling prices are not directly observable for our all-access and limited-access technology arrangements, which are composed of cloud-based subscriptions, time-based licenses, and perpetual licenses. For these technology arrangements, we use the residual estimation method due to a limited number of standalone transactions and/or prices that are highly variable. Variable consideration We have also entered into at-risk and shared savings arrangements with certain customers whereby we receive variable consideration based on the achievement of measurable improvements which may include cost savings or performance against metrics. For these arrangements, we estimate revenue using the most likely amount that we will receive. Estimates are based on our historical experience and best judgment at the time to the extent it is probable that a significant reversal of revenue recognized will not occur. Due to the nature of our arrangements, certain estimates may be constrained until the uncertainty is further resolved. Contract balances Contract assets resulting from services performed prior to invoicing customers are recorded as unbilled accounts receivable and are presented on our condensed consolidated balance sheets in aggregate with accounts receivable. Unbilled accounts receivable generally become billable at contractually specified dates or upon the attainment of contractually defined milestones. As of September 30, 2020 and December 31, 2019, the unbilled accounts receivable included in accounts receivable on our condensed consolidated balance sheets was $1.9 million and $2.9 million, respectively. We record contract liabilities as deferred revenue when cash payments are received or due in advance of performance. Deferred revenue primarily relates to the advance consideration received from the customer. As of September 30, 2020 and December 31, 2019, the total of current and non-current deferred revenue on our condensed consolidated balance sheets was $36.7 million and $32.1 million, respectively. Deferred Costs We capitalize sales commissions, and associated fringe costs, such as payroll taxes, paid to direct sales personnel and other incremental costs of obtaining contracts with customers, provided we expect to recover those costs. We determine that costs should be deferred based on our sales compensation plans when the commissions are incremental and would not have occurred absent the customer contract. As of September 30, 2020, $0.4 million of deferred commissions are expected to be amortized within the next 12 months and are included in prepaid expenses and other assets on the consolidated balance sheets. The remaining $1.1 million of deferred commissions are included in non-current other assets. Commissions paid upon the initial acquisition of a contract are amortized on a straight-line basis over an estimated period of benefit of four years. Amortization is recognized on a straight-line basis commensurate with the pattern of revenue recognition. The period of benefit was estimated by considering factors such as estimated average customer life, the rate of technological change in our subscription service, and the impact of competition in our industry. As our average customer life significantly exceeded the rate of change in our technology, we concluded that the rate of change in the technology underlying our subscription service was the most significant factor in determining the period of benefit for which the asset relates. In evaluating the rate of change in our technology, we considered the competition in our industry, our commitment to continuous innovation, and the frequency of product, platform, and technology updates. We determined that the impact of competition in our industry is reflected in the period of benefit through the rate of technological change. Amortization of deferred contract acquisition costs is included within sales and marketing expense in the condensed consolidated statements of operations. We defer certain costs to fulfill a contract when the costs are expected to be recovered, are directly related to in-process contracts and enhance resources that will be used in satisfying performance obligations in the future. These deferred fulfillment costs primarily consist of employee compensation incurred as part of the implementation of new contracts. As of September 30, 2020 and December 31, 2019, $0.3 million and $0.9 million, respectively, of deferred fulfillment costs were included in prepaid expenses and other assets on the condensed consolidated balance sheets. Amortization of deferred fulfillment costs is included within cost of revenue in the condensed consolidated statements of operations. We periodically review these deferred costs to determine whether events or changes in circumstances have occurred that could impact the period of benefit. There were no impairment losses recorded during the periods presented. Cost of revenue, excluding depreciation and amortization Cost of technology revenue primarily consists of costs associated with hosting and supporting our technology, including third-party cloud computing and hosting costs, contractor costs, and salary and related personnel costs for our cloud services and support teams. Cost of professional services revenue primarily consists of salary and related personnel costs, travel-related costs, and independent contractor costs. Cost of revenue excludes costs related to depreciation and amortization. Cash and cash equivalents We consider all highly liquid investments purchased with a remaining maturity of three months or less at the time of acquisition to be cash equivalents. Short-term investments Our investment policy limits investments to highly-rated instruments that mature in less than 12 months. We classify our short-term investments as available for sale. Accounts receivable Accounts receivable are non-interest bearing and are recorded at the original invoiced amount less an allowance for credit losses based on the probability of future collections. We adopted ASU 2016-13 effective January 1, 2020. ASU 2016-13 replaces the existing incurred loss impairment model with an expected loss model which requires the use of forward-looking information to calculate credit loss estimates, which results in earlier recognition of credit losses. The allowance is based on our estimate of expected credit losses for outstanding trade accounts receivables and unbilled receivables. We determine expected credit losses based on historical write-off experience, an analysis of the aging of outstanding receivables, customer payment patterns, the establishment of specific reserves for customers in an adverse financial condition, and our expectations of changes in macro-economic conditions, including the current COVID-19 pandemic, that may impact the collectability of outstanding receivables. We reassess the adequacy of the allowance for credit losses each reporting period. The following table presents a rollforward of the allowance for credit losses (in thousands): Allowance for Credit Losses on Accounts Receivable Balance at January 1, 2020 $ 534 Current period provision for expected credit losses 822 Less: Write-offs, net of recoveries (170) Balance at September 30, 2020 $ 1,186 Property and equipment Property and equipment are stated at historical cost less accumulated depreciation. Repairs and maintenance costs that do not extend the useful life or improve the related assets are expensed as incurred. Depreciation and amortization is computed using the straight-line method over the estimated useful lives of the assets. The estimated useful life of each asset category is as follows: Computer equipment 2-3 years Furniture and fixtures 3 years Leasehold improvements Lesser of lease term or estimated useful life Computer software 2-3 years Capitalized internal-use software costs 2-3 years When there are indicators of potential impairment, we evaluate the recoverability of the carrying values by comparing the carrying amount of the applicable asset group to the estimated undiscounted future cash flows expected to be generated by the asset group over the remaining life of the primary long-lived asset in that group plus any residual value. If the carrying amount of the asset group exceeds its estimated undiscounted future net cash flows plus residual value, an impairment charge is recognized based on the amount by which the carrying value of the long-lived assets exceeds the fair value of those assets. We did not incur any long-lived impairment charges for the three and nine months ended September 30, 2020 and 2019. Intangible assets Intangible assets include developed technologies, customer relationships, customer contract backlog, and trademarks that were acquired in business combinations and asset acquisitions. Intangible assets also include the purchase of third-party computer software. The intangible assets are amortized using the straight-line method over the assets’ estimated useful lives. The estimated useful life of each asset category is as follows: Developed technologies 2-10 years Customer relationships and contract backlog 2-7 years Computer software licenses 2-5 years Trademarks 2-5 years Goodwill We continually evaluate potential acquisitions that either strategically fit within our existing portfolio or expand our portfolio into new product lines or adjacent markets. We have completed a number of acquisitions that have been accounted for as business combinations under ASC 805, Business Combinations , and have resulted in the recognition of goodwill in our condensed consolidated financial statements. This goodwill includes the know-how of the assembled workforce, the ability of the workforce to further improve technology and product offerings, customer relationships, and the expected cash flows resulting from these efforts. Goodwill may also include expected synergies resulting from the complementary strategic fit these businesses bring to existing operations. We record goodwill as the difference between the aggregate consideration paid for a business combination and the fair value of the identifiable net tangible and intangible assets acquired. Goodwill is assessed for impairment annually or more frequently if indicators of impairment are present or circumstances suggest that impairment may exist. As of January 1, 2020, we adopted ASU 2017-04, which simplifies the goodwill impairment test by eliminating the second step from the goodwill impairment test. The first step of the goodwill impairment test compares the fair value of the reporting unit with its carrying amount, including goodwill. If the fair value of the reporting unit exceeds its carrying amount, the goodwill of the reporting unit is not considered impaired. If the carrying amount of the reporting unit exceeds its fair value, we would recognize an impairment charge for the amount by which the carrying amount exceeds the reporting unit’s fair value. Business combinations We account for an acquisition as a business combination if we obtain control of a business. Assets and liabilities acquired in a business combination generally are recorded at fair value and any associated acquisition costs are expensed as incurred in general and administrative expenses. Fair value estimates related to business combinations are based on a complex series of judgments about future events and uncertainties and rely heavily on estimates and assumptions. Significant estimation is required by management in determining the fair value of the customer relationship intangible assets and technology-related intangible assets. The significant estimation is primarily due to the judgmental nature of the inputs to the valuation models used to measure the fair value of these intangible assets, as well as the sensitivity of the respective fair values to the underlying significant assumptions. We typically use the income approach or cost approach to measure the fair value of intangible assets. Significant inputs include the amount of cash flows, the expected period of the cash flows, and the discount rates. The significant assumptions used to estimate the fair value of the intangible assets included revenue growth rates, customer attrition rates, amount and expected period of cash flows, replacement costs, and discount rates. These significant assumptions are forward-looking and could be affected by future economic and market conditions. During the three and nine months ended September 30, 2020, we expensed $1.4 million and $2.7 million, respectively, of acquisition transaction costs related to acquisitions as incurred that are included in general and administrative expense in our condensed consolidated statements of operations. Contingent consideration liabilities Our acquisition consideration in business combinations may include an estimate for contingent consideration that will be paid if certain earn-out performance targets are met. The resulting contingent consideration liabilities are categorized as a Level 3 fair value measurement because we estimate projections during the earn-out period utilizing unobservable inputs, including various potential pay-out scenarios. Changes to the unobservable inputs could have a material impact on our condensed consolidated financial statements. We value the expected contingent consideration and the corresponding liabilities using the Monte Carlo method based on estimates of potential pay-out scenarios. Probabilities are applied to each potential scenario and the resulting values are discounted using a rate that considers weighted average cost of capital as well as a specific risk premium associated with the riskiness of the earn-out itself, the related projections, and volatility in the fair value of our common stock. The portion of the contingent consideration liabilities that will be settled in shares of our common stock are classified as a component of non-current liabilities in our consolidated balance sheets, while the portion to paid in cash are classified as a component of current liabilities. Changes to the contingent consideration liabilities are reflected as part of general and administrative expense in our consolidated statements of operations. Advertising costs All advertising costs are expensed as incurred. We recorded advertising costs of $2.2 million and $3.4 million for the three months ended September 30, 2020 and 2019, respectively, and $3.2 million and $4.5 million for the nine months ended September 30, 2020 and 2019, respectively. Development costs and internal-use software For technology products that are developed to be licensed externally, we determined that technological feasibility is reached shortly before the products are ready for general release. Any costs associated with software development between the time technological feasibility is reached and general release are inconsequential. We capitalize certain development costs incurred in connection with our internal-use software. These capitalized costs are primarily related to the software platforms that are hosted by us and accessed by our customers on a subscription basis. Costs incurred in the preliminary stages of development are expensed as incurred as research and development costs. Once an application has reached the development stage, internal and external costs, if direct and incremental, are capitalized until the software is substantially complete and ready for its intended use. We also capitalize costs related to specific upgrades and enhancements when it is probable the expenditures will result in additional functionality. Capitalized costs are recorded as part of property and equipment. Maintenance and training costs are expensed as incurred. Internal-use software is amortized on a straight-line basis over its estimated useful life. Stock-based compensation Stock-based awards, including stock options and RSUs, are measured and recognized in our condensed consolidated financial statements based on the fair value of the award on the grant date. For awards subject to performance conditions, we record expense when the performance condition becomes probable. We record forfeitures of stock-based awards as the actual forfeitures occur. We estimate the fair value of stock option awards on the grant date using the Black-Scholes option pricing model. We have issued two types of employee stock-based awards, standard and two-tier. Our standard stock-based awards vest solely on a service-based condition. For these awards, we recognize stock-based compensation expense on a straight-line basis over the vesting period. Two-tier employee stock-based awards, contain both a service-based condition and performance condition, defined as the earlier of (i) an acquisition or change in control of the company or (ii) upon the occurrence of an initial public offering by the Company. A change in control event and effective registration event are not deemed probable until consummated; accordingly, no expense was recorded related to two-tier stock-based awards until the performance condition became probable of occurring. Awards that contain both service-based and performance conditions were recognized using the accelerated attribution method once the performance condition is probable of occurring. The service-based condition is generally a service period of four years. Stock-based compensation expense related to purchase rights issued under the 2019 Health Catalyst Employee Stock Purchase Plan (ESPP) is based on the Black-Scholes option-pricing model fair value of the estimated number of awards as of the beginning of the offering period. Stock-based compensation expense is recognized using the straight-line method over the offering period. The compensation expense for non-employees is recognized, without changes in the fair value of the award, in the same period and in the same manner as though we had paid cash for the services, which is typically the vesting period of the respective award. Income taxes Deferred income tax balances are accounted for using the asset and liability method and reflect the effects of temporary differences between the financial reporting and tax bases of our assets and liabilities using enacted tax rates expected to apply when taxes are actually paid or recovered. In addition, deferred tax assets and liabilities are recorded for net operating loss (NOL) and credit carryforwards. A valuation allowance is provided against deferred tax assets unless it is more likely than not that they will be realized based on all available positive and negative evidence. Such evidence includes, but is not limited to, recent cumulative earnings or losses, expectations of future taxable income by taxing jurisdiction, and the carry-forward periods available for the utilization of deferred tax assets. We use a two-step approach to recognize and measure uncertain income tax positions. The first step is to evaluate the tax position for recognition by determining if the weight of available evidence indicates it is more likely than not that the position will be sustained upon audit. The second step is to measure the tax benefit as the largest amount, which is more than 50% likely of being realized upon ultimate settlement. We do not accrue interest and penalties related to unrecognized tax benefits within the provision for income taxes because we have NOLs. Significant judgment is required to evaluate uncertain tax positions. Although we believe that we have adequately reserved for our uncertain tax positions, we can provide no assurance that the final tax outcome of these matters will not be materially different. We evaluate our uncertain tax positions on a regular basis and evaluations are based on a number of factors, including changes in facts and circumstances, changes in tax law, such as the Tax Cuts and Jobs Act of 2017, correspondence with tax authorities during the course of an audit, and effective settlement of audit issues. To the extent that the final tax outcome of these matters is dif

Business Combinations

Business Combinations	9 Months Ended
	Sep. 30, 2020
Business Combinations [Abstract]
Business Combinations	Business Combinations The business acquisitions discussed below are included in our results of operations from their respective dates of acquisition. Able Health, Inc. On February 21, 2020, we acquired Able Health, Inc. (Able Health) , a leading software-as-a-service provider of quality and regulatory measurement tracking and reporting to healthcare providers and risk-bearing entities, in a transaction accounted for as a business combination . The acquisition consideration transferred was $21.5 million and was comprised of net cash consideration of $15.2 million, Health Catalyst common shares with a fair value of $3.3 million, and contingent consideration based on achievement of Able Health specified incremental customer billings for the year ending December 31, 2020, with an initial fair value of $3.0 million. The acquisition consideration is subject to certain working capital escrow adjustments. The purchase resulted in Health Catalyst acquiring 100% ownership in Able Health. We believe this acquisition will strengthen Health Catalyst’s Quality and Regulatory Measures capabilities. An additional 179,392 shares of our common stock subject to restriction agreements, or restricted shares, were issued pursuant to the terms of the acquisition agreement and 60,000 restricted stock units were issued in connection with the acquisition agreement. The value of these restricted shares and restricted stock units will be recognized as post-combination stock-based compensation expense over their respective vesting terms. The vesting of the restricted shares is subject to one year of continuous service by the applicable team members and shall vest on the one-year anniversary of the acquisition closing date and t he service-based condition for the restricted stock units issued pursuant to the terms of the acquisition agreement is satisfied over two years with a 50% cliff vesting period of one year and ratable quarterly vesting thereafter. Refer to Note 12 for additional details related to our stock-based compensation. The preliminary allocation of the consideration transferred is based on a preliminary valuation and is subject to potential adjustments. Balances subject to adjustment primarily include tax-related matters, including tax basis of acquired assets and liabilities. During the measurement period, we may record adjustments to the provisional amounts recognized in our initial accounting for the acquisition. We expect the allocation of the consideration transferred to be final within the measurement period (up to one year from the acquisition date). There were no measurement period adjustments recorded during the three and nine months ended September 30, 2020. The following table summarizes the acquisition-date fair value of consideration transferred and the identifiable assets purchased and liabilities assumed as part of our acquisition of Able Health (in thousands): Assets acquired: Accounts receivable $ 633 Prepaid expenses and other assets 57 Developed technologies 7,500 Customer relationships 600 Trademarks 100 Total assets acquired 8,890 Less liabilities assumed: Accounts payable and other current liabilities 91 Deferred revenue 762 Net deferred tax liabilities 1,280 Total liabilities assumed 2,133 Total assets acquired, net 6,757 Goodwill 14,725 Total consideration transferred, net of cash acquired $ 21,482 The acquired intangible assets were valued utilizing either an income approach or a cost approach as deemed most applicable, and include customer relationships, developed technology, and trademarks that will be amortized on a straight-line basis over their estimated useful lives of six years, three years, and two years, respectively. The resulting goodwill from the Able Health acquisition was fully allocated to the technology reporting unit and is not deductible for income tax purposes. The post-acquisition revenue of Able Health is not presented as the amount was not significant to our results of operations for the three and nine months ended September 30, 2020. Net income (loss) information for Able Health after the acquisition date through September 30, 2020 is not presented as the acquired business was integrated into our operations immediately following the acquisition and is impractical to quantify. Healthfinch, Inc. On July 31, 2020, we acquired Healthfinch, Inc. (Healthfinch), which provides a workflow integration engine delivering insights and analytics into EMR workflows to automate physicians’ ability to close patient care gaps in real-time, in a transaction accounted for as a business combination. We believe this acquisition will strengthen our existing population health capabilities. The acquisition consideration transferred was $50.5 million and was comprised of net cash consideration of $16.9 million, Health Catalyst common shares with a fair value of $27.8 million, and contingent consideration based on certain earn-out performance targets for Healthfinch during an earn-out period that ends on July 31, 2021, with an initial fair value of $5.8 million. The purchase resulted in Health Catalyst acquiring 100% ownership in Healthfinch. The preliminary allocation of the consideration transferred is based on a preliminary valuation and is subject to potential adjustments. Balances subject to adjustment primarily include tax-related matters, including tax basis of acquired assets and liabilities. During the measurement period, we may record adjustments to the provisional amounts recognized in our initial accounting for the acquisition. We expect the allocation of the consideration transferred to be final within the measurement period (up to one year from the acquisition date). There were no measurement period adjustments recorded during the three months ended September 30, 2020. The following table summarizes the acquisition-date fair value of consideration transferred and the identifiable assets purchased and liabilities assumed as part of our acquisition of Healthfinch (in thousands): Assets acquired: Accounts receivable $ 1,408 Prepaid expenses and other assets 347 Developed technologies 8,100 Customer relationships and contract backlog 10,000 Trademarks 200 Total assets acquired 20,055 Less liabilities assumed: Accounts payable and other current liabilities 408 Deferred revenue 2,100 Total liabilities assumed 2,508 Total assets acquired, net 17,547 Goodwill 32,960 Total consideration transferred, net of cash acquired $ 50,507 The acquired intangible assets were valued utilizing either an income approach or a cost approach as deemed most applicable, and include customer relationships and contract backlog, developed technology, and trademarks that will be amortized on a straight-line basis over their estimated useful lives of seven years, three years, and two years, respectively. The resulting goodwill from the Healthfinch acquisition was fully allocated to the technology reporting unit and is not deductible for income tax purposes. The post-acquisition revenue of Healthfinch is not presented as the amount was not significant to our results of operations for the three and nine months ended September 30, 2020. Net income (loss) information for Healthfinch after the acquisition date through September 30, 2020 is not presented as the acquired business was integrated into our operations immediately following the acquisition and is impractical to quantify. Vitalware, LLC On September 1, 2020, we acquired Vitalware, LLC (Vitalware) , a provider of revenue workflow optimization and analytics SaaS technology solutions to healthcare organizations, in a transaction accounted for as a business combination . Vitalware’s flagship offering is a chargemaster management solution that delivers results for the complex regulatory and compliance functions needed by healthcare provider systems. Additionally, Vitalware brings to bear newer product suites to help health systems capture lost revenue and to support compliance with expanding pricing transparency regulation. The acquisition consideration transferred was $119.2 million and was comprised of net cash consideration of $69.6 million, Health Catalyst common shares with a fair value of $41.3 million, and contingent consideration based on certain earn-out performance targets for Vitalware during an earn-out period that ends on March 31, 2021, with an initial fair value of $8.3 million. The acquisition consideration is subject to certain working capital escrow adjustments. The purchase resulted in Health Catalyst acquiring 100% ownership in Vitalware. An additional 203,997 shares of our common stock subject to a restriction agreement, or restricted shares, were issued pursuant to the terms of the acquisition agreement. The value of these restricted shares will be recognized as post-combination stock-based compensation expense on a straight-line basis over the 12-month vesting term. 75% of these restricted shares will vest on a monthly basis over a term of approximately one year with the remaining 25% vesting on the one-year anniversary of the acquisition closing date. Refer to Note 12 for additional details related to our stock-based compensation. The preliminary allocation of the consideration transferred is based on a preliminary valuation and is subject to potential adjustments. Balances subject to adjustment primarily include the potential impact of net working capital adjustments on the acquisition consideration. During the measurement period, we may record adjustments to the provisional amounts recognized in our initial accounting for the acquisition. We expect the allocation of the consideration transferred to be final within the measurement period (up to one year from the acquisition date). There were no measurement period adjustments recorded during the three months ended September 30, 2020. The following table summarizes the acquisition-date fair value of consideration transferred and the identifiable assets purchased and liabilities assumed as part of our acquisition of Vitalware (in thousands): Assets acquired: Accounts receivable $ 3,220 Prepaid expenses and other assets 469 Developed technologies 18,000 Customer relationships and contract backlog 43,000 Trademarks 1,400 Total assets acquired 66,089 Less liabilities assumed: Accounts payable and other current liabilities 766 Deferred revenue 2,589 Total liabilities assumed 3,355 Total assets acquired, net 62,734 Goodwill 56,443 Total consideration transferred, net of cash acquired $ 119,177 The acquired intangible assets were valued utilizing an income approach, and include customer relationships, contract backlog, developed technology, and trademarks that will be amortized on a straight-line basis over their estimated useful lives of seven years, two years, four years, and for trademarks two The post-acquisition revenue of Vitalware was $0.9 million for the three months ended September 30, 2020. Net income (loss) information for Vitalware after the acquisition date through September 30, 2020 is not presented as the acquired business was integrated into our operations immediately following the acquisition and is impractical to quantify. Unaudited Pro Forma Financial Information The following table reflects our unaudited pro forma combined results of operations for the three and nine months ended September 30, 2020 and 2019 as if the acquisitions of Able Health, Healthfinch, and Vitalware had taken place on January 1, 2019: Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Total pro forma revenues $ 52,525 $ 44,745 $ 154,363 $ 123,998 Pro forma net loss (27,159) (28,828) (83,233) (69,303) The unaudited pro forma information is not intended to present actual results that would have been attained had the acquisition been completed as of January 1, 2019 or to project potential results as of any future date or for any future periods.

Revenue

Revenue	9 Months Ended
	Sep. 30, 2020
Revenue from Contract with Customer [Abstract]
Revenue	Revenue Disaggregation of revenue The following table represents Health Catalyst’s revenue disaggregated by type of arrangement (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Recurring technology $ 27,964 $ 21,160 $ 78,150 $ 61,393 Professional services 19,227 18,263 57,416 50,047 Total revenue $ 47,191 $ 39,423 $ 135,566 $ 111,440 For the three months ended September 30, 2020 and 2019, and for the nine months ended September 30, 2020 and 2019, less than 0.1% of revenue was related to contracts with customers located outside of the United States. Deferred revenue includes advance customer payments and billings in excess of revenue recognized. For the three months ended September 30, 2020 and 2019, 44% and 48%, respectively, of the revenue recognized was included in deferred revenue at the beginning of the period. For the nine months ended September 30, 2020 and 2019, 19% and 18%, respectively, of the revenue recognized was included in deferred revenue at the beginning of the period. Transaction price allocated to the remaining performance obligations three

Goodwill and Intangible Assets

Goodwill and Intangible Assets	9 Months Ended
	Sep. 30, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	Goodwill and Intangible Assets We operate our business in two operating segments that also represent our reporting units. Our reporting units are organized based on our technology and professional services. Goodwill by reporting unit is as follows (in thousands): As of As of 2020 2019 Technology $ 107,040 $ 2,912 Professional services 782 782 Total goodwill $ 107,822 $ 3,694 As of September 30, 2020, intangible assets consisted of the following (in thousands): Gross Accumulated Amortization Net Developed technologies $ 69,729 $ (21,911) $ 47,818 Customer relationships and contracts 57,764 (4,444) 53,320 Computer software licenses 7,291 (4,115) 3,176 Trademarks 1,700 (88) 1,612 Total intangible assets $ 136,484 $ (30,558) $ 105,926 As of December 31, 2019, intangible assets consisted of the following (in thousands): Gross Accumulated Amortization Net Developed technologies $ 36,129 $ (16,548) $ 19,581 Customer relationships and contracts 4,164 (2,773) 1,391 Computer software licenses 7,114 (2,576) 4,538 Trademarks 100 (75) 25 Total intangible assets $ 47,507 $ (21,972) $ 25,535 The increase in goodwill and intangible assets is primarily due to our acquisitions of Able Health, Healthfinch, and Vitalware during the nine months ended September 30, 2020. There was no impairment of goodwill or intangible assets for the three and nine months ended September 30, 2020 and 2019. Intangible assets are amortized using the straight-line method over the estimated useful lives. Amortization expense of acquired intangible assets was $4.3 million and $1.6 million for the three months ended September 30, 2020, and 2019, respectively, and $8.8 million and $4.7 million for the nine months ended September 30, 2020 and 2019, respectively. Amortization expense for intangible assets is included in depreciation and amortization in our condensed consolidated statements of operations.

Property and Equipment

Property and Equipment	9 Months Ended
	Sep. 30, 2020
Property, Plant and Equipment [Abstract]
Property and Equipment	Property and Equipment Property and equipment consisted of the following (in thousands): As of As of 2020 2019 Computer equipment $ 7,794 $ 7,951 Leasehold improvements 4,182 2,234 Furniture and fixtures 1,041 1,030 Capitalized internal-use software costs 2,617 1,866 Computer software 958 972 Capital lease equipment 37 37 Total property and equipment 16,629 14,090 Less: accumulated depreciation (11,310) (9,795) Property and equipment, net $ 5,319 $ 4,295 Our long-lived assets are located in the United States. Depreciation expense totaled $0.7 million and $0.7 million for the three months ended September 30, 2020 and 2019, respectively, and $2.2 million and $2.2 million for the nine months ended September 30, 2020 and 2019, respectively. Depreciation expense includes amortization of assets recorded under a capital lease and the amortization of capitalized internal-use software costs.

Short-term Investments

Short-term Investments	9 Months Ended
	Sep. 30, 2020
Investments, Debt and Equity Securities [Abstract]
Short-term Investments	Short-term Investments Our investment policy limits investments to highly-rated instruments that mature in less than 12 months. We classify our short-term investments as available for sale. Available-for-sale securities are recorded on our condensed consolidated balance sheets at fair market value and any unrealized gains or losses are reported as part of other comprehensive loss on our condensed consolidated statements of comprehensive loss. We determine realized gains or losses on the sales of investments through the specific identification method and record such gains or losses as part of interest and other expense, net on our condensed consolidated statements of operations. We did not have significant realized gains or losses on investments during the three and nine months ended September 30, 2020 and 2019. We measure the fair value of investments on a recurring basis. Accrued interest receivables related to our available-for-sale securities of $0.7 million and $0.9 million as of September 30, 2020 and December 31, 2019 were included within prepaid expenses and other assets on our condensed consolidated balance sheets. The following table summarizes, by major security type, our cash equivalents and short-term investments that are measured at fair value on a recurring basis (in thousands) as of September 30, 2020: Amortized Cost Unrealized Gains Unrealized Losses Fair Value Cash equivalents Short-term Investments Money market funds $ 100,913 $ — $ — $ 100,913 $ 100,913 $ — U.S. Treasury notes 49,571 23 — 49,594 — 49,594 Commercial paper 51,883 — — 51,883 — 51,883 Corporate bonds 59,364 30 (1) 59,393 — 59,393 Asset-backed securities 3,027 1 — 3,028 — 3,028 Total $ 264,758 $ 54 $ (1) $ 264,811 $ 100,913 $ 163,898 The following table summarizes, by major security type, our cash equivalents and short-term investments that are measured at fair value on a recurring basis (in thousands) as of December 31, 2019: Amortized Cost Unrealized Gains Unrealized Losses Fair Value Cash equivalents Short-term Investments Money market funds $ 17,175 $ — $ — $ 17,175 $ 17,175 $ — US treasury notes 58,130 34 — 58,164 — 58,164 Commercial paper 46,973 — — 46,973 — 46,973 Corporate bonds 64,978 27 (5) 65,000 — 65,000 Asset-backed securities 40,090 18 — 40,108 — 40,108 Total $ 227,346 $ 79 $ (5) $ 227,420 $ 17,175 $ 210,245 On a quarterly basis we evaluate unrealized losses on our available-for-sale debt securities and the related accrued interest receivables to determine whether a decline in the fair value below the amortized cost basis is due to credit-related factors or noncredit-related factors. We do not intend to sell investments that are in an unrealized loss position and it is not likely that we will be required to sell any investments before recovery of their amortized cost basis. As of September 30, 2020 and December 31, 2019, there were no material unrealized losses due to credit-related factors.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	9 Months Ended
	Sep. 30, 2020
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	Fair Value of Financial Instruments Assets and liabilities measured at fair value on a recurring basis as of September 30, 2020 were as follows (in thousands): September 30, 2020 Level 1 Level 2 Level 3 Total Money market funds $ 100,913 $ — $ — $ 100,913 U.S. Treasury notes 49,594 — — 49,594 Commercial paper — 51,883 — 51,883 Corporate bonds — 59,393 — 59,393 Asset-backed securities — 3,028 — 3,028 Contingent consideration — — (16,172) (16,172) Total $ 150,507 $ 114,304 $ (16,172) $ 248,639 Assets measured at fair value on a recurring basis as of December 31, 2019 were as follows (in thousands): December 31, 2019 Level 1 Level 2 Level 3 Total Money market funds $ 17,175 $ — $ — $ 17,175 U.S. Treasury notes 58,164 — — 58,164 Commercial paper — 46,973 — 46,973 Corporate bonds — 65,000 — 65,000 Asset-backed securities $ — $ 40,108 $ — $ 40,108 Total $ 75,339 $ 152,081 $ — $ 227,420 As of December 31, 2019, there were no liabilities measured at fair value on a recurring basis. There were no transfers between Level 1 and Level 2 during the three and nine months ended September 30, 2020 and 2019. The Able Health acquisition consideration includes an estimate for contingent consideration of up to 145,036 shares of our common stock that will be issued if certain incremental billing targets for Able Health are met during an earn-out period that ends on December 31, 2020. The Healthfinch acquisition consideration includes an estimate for contingent consideration based on certain earn-out performance targets for Healthfinch during an earn-out period that ends on July 31, 2021. The Healthfinch contingent consideration will be paid in a combination of cash and shares of our common stock in the same proportion as the initial acquisition consideration. The Vitalware acquisition consideration includes an estimate for contingent consideration based on certain earn-out performance targets for Vitalware during an earn-out period that ends on March 31, 2021. The Vitalware contingent consideration will be paid in a combination of approximately 50% cash and 50% in shares of our common stock. The resulting contingent consideration liabilities are categorized as Level 3 fair value measurements. The following table sets forth a summary of the changes in the estimated fair value of the contingent consideration liabilities, which is measured at fair value on a recurring basis using significant unobservable inputs (in thousands): Fair Value Measurements Using Significant Unobservable Inputs (Level 3) Balance at December 31, 2019 $ — Initial contingent consideration liabilities from acquisitions (see Note 2) 17,176 Change in fair value of contingent consideration liabilities (1,004) Balance at September 30, 2020 $ 16,172

Accrued liabilities

Accrued liabilities	9 Months Ended
	Sep. 30, 2020
Payables and Accruals [Abstract]
Accrued liabilities	Accrued liabilities As of September 30, 2020 and December 31, 2019, accrued liabilities consisted of the following (in thousands): As of As of 2020 2019 Accrued compensation and benefit expenses $ 7,041 $ 4,278 Interest payable 2,636 — Other accrued liabilities 4,384 4,666 Total accrued liabilities $ 14,061 $ 8,944

Convertible Senior Notes and Cr

Convertible Senior Notes and Credit Facilities	9 Months Ended
	Sep. 30, 2020
Debt Disclosure [Abstract]
Convertible Senior Notes and Credit Facilities	Convertible Senior Notes and Credit Facilities Convertible Senior Notes On April 14, 2020, we issued $230.0 million in aggregate principal amount of 2.50% Convertible Senior Notes due 2025 (the Notes), in a private placement to qualified institutional buyers exempt from registration under the Securities Act (the Note Offering). The net proceeds from the issuance of the Notes were approximately $222.5 million, after deducting the initial purchasers’ discounts and offering expenses payable by us. The Notes are governed by an indenture (the Indenture) between us, as the issuer, and U.S. Bank National Association, as trustee. The Notes are our senior, unsecured obligations and accrue interest payable semiannually in arrears on April 15 and October 15 of each year, beginning on October 15, 2020, at a rate of 2.50% per year. The Notes will mature on April 15, 2025, unless earlier converted, redeemed, or repurchased. The Indenture does not contain any financial or operating covenants or restrictions on the payments of dividends, the incurrence of indebtedness, or the issuance or repurchase of securities by us or any of our subsidiaries. We may not redeem the notes prior to April 20, 2023. On or after April 20, 2023, we may redeem, for cash, all or a portion of the notes, at our option, if the last reported sale price of our common stock has been at least 130% of the conversion price then in effect for at least 20 trading days (whether or not consecutive), including the trading day immediately preceding the date on which we provide notice of redemption, during any 30 consecutive trading day period ending on, and including, the trading day immediately preceding the date on which we provide notice of redemption at a redemption price equal to 100% of the principal amount of the Notes to be redeemed, plus accrued and unpaid interest to, but excluding, the redemption date. No sinking fund is provided for the notes. The Notes have an initial conversion rate of 32.6797 shares of our common stock per $1,000 principal amount of Notes (which is equivalent to an initial conversion price of approximately $30.60 per share of our common stock). Following certain corporate events that occur prior to the maturity date, we will increase the conversion rate for a holder who elects to convert its Notes in connection with such corporate event. Additionally, upon the occurrence of a corporate event that constitutes a “fundamental change” per the Indenture, holders of the Notes may require the Company to repurchase for cash all or a portion of their Notes at a purchase price equal to 100% of the principal amount of the Notes plus accrued and unpaid interest. Holders of the Notes may convert all or any portion of their Notes at any time prior to the close of business on October 14, 2024, in integral multiples of $1,000 principal amount, only under the following circumstances: • During any calendar quarter commencing after the calendar quarter ended on June 30, 2020 (and only during such calendar quarter), if the last reported sale price of our common stock for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on, and including, the last trading day of the immediately preceding calendar quarter is greater than or equal to 130% of the conversion price on each applicable trading day; • During the five business day period after any five consecutive trading day period (the “measurement period”) in which the trading price as defined in the Indenture per $1,000 principal amount of Notes for each trading day of the measurement period was less than 98% of the product of the last reported sale price of our common stock and the conversion rate on each such trading day; • If we call such notes for redemption, at any time prior to the close of business on the scheduled trading day immediately preceding the redemption date; or • Upon the occurrence of specified corporate events described in the Indenture. On or after October 15, 2024, until the close of business on the second scheduled trading day immediately preceding the maturity date, holders may convert all or any portion of their Notes at the conversion rate at any time irrespective of the foregoing circumstances. Upon conversion, holders will receive cash, shares of our common stock or a combination of cash and shares of common stock, at our election. During the three and nine months ended September 30, 2020, the conditions allowing holders of the Notes to convert were not met. The Notes are therefore not currently convertible and are classified as long-term debt. We account for the Notes as separate liability and equity components. We determined the carrying amount of the liability component as the present value of its cash flows using a discount rate of approximately 10% based on comparable debt transactions for similar companies. The estimated interest rate was applied to the Notes, which resulted in a fair value of the liability component of $166.7 million upon issuance, calculated as the present value of future contractual payments based on the $230.0 million aggregate principal amount. The excess of the principal amount of the liability component over its carrying amount, or the debt discount, is amortized to interest expense over the term of the Notes using the effective interest method. The $63.3 million difference between the gross proceeds received from issuance of the Notes of $230.0 million and the estimated fair value of the liability component represents the equity component, or the conversion option, of the Notes and was recorded in additional paid-in capital. The equity component is not remeasured as long as it continues to meet the conditions for equity classification. We allocated issuance costs related to the issuance of the Notes to the liability and equity components using the same proportions as the initial carrying value of the Notes. Issuance costs attributable to the liability component were $5.5 million and are being amortized to interest expense using the effective interest method over the term of the Notes. Issuance costs attributable to the equity component were $2.1 million and are netted with the equity component of the Notes in stockholders’ equity on the condensed consolidated balance sheets. The net carrying value of the liability component of the Notes was as follows (in thousands): September 30, 2020 Principal $ 230,000 Less: Unamortized debt discount (58,763) Less: Unamortized issuance costs (5,037) Net carrying amount $ 166,200 The net carrying value of the equity component of the Notes was as follows (in thousands): September 30, 2020 Proceeds allocated to the conversion option (debt discount) $ 63,270 Less: Issuance costs (2,057) Net carrying amount $ 61,213 The interest expense recognized related to the Notes was as follows (in thousands): Three Months Ended Nine Months Ended Contractual interest expense $ 1,437 $ 2,635 Amortization of debt issuance costs and discount 2,720 4,931 Total $ 4,157 $ 7,566 Based on the closing price of our common stock of $36.60 on September 30, 2020, the if-converted value of the Notes was $45.1 million more than their respective principal amount. Capped Calls On April 8, 2020, concurrently with the pricing of the Notes, we entered into privately negotiated capped call transactions (Base Capped Calls) with certain option counterparties. In addition, in connection with the initial purchasers’ exercise in full of their option to purchase additional Notes, on April 9, 2020, we entered into additional capped call transactions (together with the Base Capped Calls, the Capped Calls) with each of the option counterparties. We used approximately $21.7 million of the net proceeds from the Note Offering to pay the cost of the Capped Calls and allocated issuance costs. The Capped Calls have initial cap prices of $42.00 per share, subject to certain adjustments. The Capped Calls are expected generally to reduce the potential dilution to our common stock upon any conversion of Notes and/or offset any cash payments we are required to make in excess of the principal amount of converted Notes, as the case may be, with such reduction and/or offset subject to the cap price. The Capped Calls are separate transactions that we entered into with the option counterparties, and are not part of the terms of the Notes. As the Capped Call transactions are considered indexed to our own stock and are considered equity classified, they will be recorded in stockholders’ equity and will not be accounted for as derivatives. The cost incurred in connection with the Capped Calls was recorded as a reduction to additional paid-in capital on our condensed consolidated balance sheets. Credit Facilities As of December 31, 2019, our term credit facilities consisted of the following, excluding unamortized debt discount and issue costs of $1.8 million (in thousands): Balance Remaining Capacity Interest Rate Basis Rate OrbiMed term loan $ 50,000 $ 30,000 10.00% Higher of LIBOR plus 7.5% and 10.0% SVB revolving line of credit — 5,000 5.25% Prime plus 0.50% Total credit facilities 50,000 $ 35,000 Less: Current portion of credit facilities — Credit facilities, less current portion $ 50,000 OrbiMed term loan On February 6, 2019, we entered into a debt financing agreement (the Credit Agreement) with OrbiMed Royalty Opportunities II, LP (OrbiMed) where we obtained an $80.0 million senior term loan commitment, with $50.0 million available and up to an additional $30.0 million contingently available on or prior to March 31, 2020 (the Delayed Draw Commitment). We paid $2.4 million in fees related to the establishment of the OrbiMed term loan and incurred $0.3 million in debt issuance costs. The Delayed Draw Commitment was contingent upon our achievement of minimum levels of technology revenues ranging from technology revenues for the latest 12 months of at least $60.0 million to borrow up to $10.0 million, to a minimum of $80.0 million in technology revenues to borrow between $25.0 million and $30.0 million. The contractual interest rate of the OrbiMed term loan was the higher of LIBOR plus 7.5% and 10.0%. Interest payments were required at the end of each month and monthly installment payments on principal begin in February 2023 and will be based on the then outstanding principal balance divided by 12. The maturity date of the OrbiMed term loan was February 6, 2024. Upon the payment of all or any portion of the principal amount on the OrbiMed term loan, we were required to pay an exit fee of 5% of the principal amount paid. This exit fee was being accreted as interest expense over the contractual term of the loan. As we elected to prepay the principal balance prior to the 48-month anniversary of the closing date we were required to pay a repayment premium of 9% of the principal balance prepaid. Amounts borrowed under the OrbiMed term loan were secured by a first priority security interest in substantially all of our assets other than intellectual property. In the event of default, OrbiMed was able to accelerate amounts outstanding, terminate the credit facility, and foreclose on the collateral. The agreement also included a financial covenant requiring the achievement of minimum trailing twelve-month revenue amounts as well as certain other financial and non-financial covenants. We were in compliance with these covenants under the terms of the OrbiMed term loan as of April 14, 2020. Extinguishment of OrbiMed term loan On April 14, 2020, we used $57.0 million of proceeds from the Note Offering to prepay in full all outstanding indebtedness, including prepayment penalties, under the Credit Agreement and terminated the Credit Agreement. We recorded a loss on debt extinguishment of $8.5 million during the three months ended June 30, 2020, including $1.5 million unamortized debt discounts and issuance costs related to the OrbiMed term loan and $7.0 million of repayment fees. SVB revolving line of credit In June 2016, we signed a Loan and Security Agreement with Silicon Valley Bank (SVB) which established a revolving line of credit based on a formula amount. On February 6, 2019, we amended the Loan and Security Agreement with SVB which reduced the revolving line of credit to a current maximum of $5.0 million with an obligation to maintain a minimum of $5.0 million cash or cash equivalents on deposit with SVB to maintain the assurance of future credit availability. The line may have been increased to $10.0 million upon request and approval by SVB. The maturity date of the revolving line of credit was amended to be February 6, 2021. Extinguishment of SVB revolving line of credit On April 8, 2020, we entered into a Pay-Off Letter Agreement with SVB, pursuant to which we paid to SVB immaterial termination costs, representing all amounts due and owing under the Amended and Restated Loan and Security Agreement (the Loan Agreement), dated as of October 6, 2017, with SVB, in exchange for, among other things, (i) full discharge of all of our obligations under the Loan Agreement; and (ii) release of security interests and other liens granted to or held by SVB as a security for our obligations.

Stockholders_ Equity (Deficit)

Stockholders’ Equity (Deficit)	9 Months Ended
	Sep. 30, 2020
Equity [Abstract]
Stockholders’ Equity (Deficit)	Stockholders’ Equity (Deficit) Amendment and Restatement of Certificate of Incorporation In connection with the IPO, the certificate of incorporation of Health Catalyst was amended and restated to, among other things, provide for the (i) authorization of 500,000,000 shares of common stock with a par value of $0.001 per share; (ii) authorization of 25,000,000 shares of undesignated preferred stock that may be issued from time to time; and (iii) establishment of a classified board of directors, divided into three classes, each of whose members will serve for staggered three-year terms. Preferred Stock Our board of directors has the authority, without further action by our stockholders, to issue up to 25,000,000 shares of preferred stock in one or more series and to fix the rights, preferences, and privileges thereof, including voting rights. As of September 30, 2020 and December 31, 2019, no shares of this preferred stock were issued and outstanding. Common stock We had 500,000,000 shares of $0.001 par value common stock authorized, of which 42,239,922 and 36,731,632 shares were legally issued and outstanding as of September 30, 2020 and December 31, 2019, respectively. The shares legally issued and outstanding as of December 31, 2019 included 52,778 shares issued to former employees with notes determined to be substantively nonrecourse and, as such, for accounting purposes were not considered to be outstanding shares of common stock. These notes were repaid in full by the former employees during the nine months ended September 30, 2020, and the shares issued are included in the outstanding shares of common stock for accounting purposes as of September 30, 2020. Each share of common stock has the right to one vote on all matters submitted to a vote of stockholders. The holders of common stock are also entitled to receive dividends whenever funds are legally available and when declared by the board of directors, subject to prior rights of holders of all classes of stock outstanding having priority rights as to dividends. No dividends have been declared or paid on our common stock through September 30, 2020.

Net Loss Per Share

Net Loss Per Share	9 Months Ended
	Sep. 30, 2020
Earnings Per Share [Abstract]
Net Loss Per Share	Net Loss Per Share The following table presents the calculation of basic and diluted net loss per share attributable to common stockholders (in thousands, except share and per share amounts): Three Months Ended Nine Months Ended 2020 2019 2020 2019 Numerator: Net loss attributable to common stockholders $ (27,326) $ (39,586) $ (71,999) $ (226,656) Denominator: Weighted-average number of shares used in calculating net loss per share attributable to common stockholders, basic and diluted 40,292,380 28,222,555 38,517,272 12,749,903 Net loss per share attributable to common stockholders, basic and diluted $ (0.68) $ (1.40) $ (1.87) $ (17.78) During the three and nine months ended September 30, 2020 and 2019, we incurred net losses and, therefore, the effect of our stock options, restricted stock units, convertible senior notes, restricted shares, and purchase rights committed or shares issued under our employee stock purchase plan were not included in the calculation of diluted net loss per share attributable to common stockholders as the effect would be anti-dilutive. The following table contains share totals with a potentially dilutive impact: As of September 30, 2020 2019 Common stock options 4,530,982 7,923,437 Restricted stock units 2,107,714 257,278 Shares related to convertible senior notes 743,665 — Restricted shares 370,639 — Employee stock purchase plan 84,166 138,470 Total potentially dilutive securities 7,837,166 8,319,185 The conversion spread of the Notes will have a potentially dilutive impact when the average market price of our common stock for a given period exceeds the conversion price of $30.60 per share. The shares related to the Notes in the table above are calculated based on the average market price of our common stock for the three months ended September 30, 2020. Capped Calls are excluded from the calculation of diluted earnings per share, as they would be antidilutive.

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 2020
Share-based Payment Arrangement [Abstract]
Stock-based Compensation	Stock-Based Compensation In 2011, our board of directors adopted the Health Catalyst, Inc. 2011 Stock Incentive Plan (2011 Plan), which provided for the direct award, sale of shares, and granting of RSUs and options for our common stock to our directors, team members, or consultants. In connection with our IPO, our board of directors adopted the 2019 Stock Option and Incentive Plan (2019 Plan). The 2019 Plan provides flexibility to our compensation committee to use various equity-based incentive awards as compensation tools to motivate our workforce, including the grant of incentive and nonstatutory stock options, restricted and unrestricted stock, RSUs, and stock appreciation rights to our directors, team members, or consultants. We have initially reserved 2,756,607 shares of our common stock (2,500,000 under the 2019 Plan and 256,607 shares under the 2011 Plan that were available immediately prior to the IPO registration date). The 2019 Plan provides that the number of shares reserved available for issuance under the plan will automatically increase each January 1, beginning on January 1, 2020, by 5% of the outstanding number of shares of our common stock on the immediately preceding December 31, or such lesser number of shares as determined by our compensation committee. As of January 1, 2020, there were an additional 1,836,581 shares reserved for issuance under the 2019 Plan. As of September 30, 2020 and December 31, 2019, there were 13,109,459 and 11,272,878 shares authorized for grant, respectively, and 2,597,856 and 2,309,370 shares available for grant, respectively, under the 2019 Plan and 2011 Plan (collectively the Stock Incentive Plan). All options were granted with an exercise price determined by the board of directors that was equal to the estimated fair value of our common stock at the date of grant, based on the information known on the date of grant. Subject to certain exceptions defined in the Stock Incentive Plan related to an employee’s termination, options generally expire on the tenth anniversary of the applicable grant date. We have issued two types of employee stock-based awards, standard and two-tier. Our standard stock-based awards vest solely on a service-based condition. For these awards, we recognize stock-based compensation based on the grant date fair value of the awards and recognize that cost using the straight-line method over the requisite service period of the award. Two-tier employee stock-based awards contain both a service-based condition and performance condition, defined as the earlier of (i) an acquisition or change in control of the company or (ii) upon the occurrence of our initial public offering. A change in control event and effective registration event are not deemed probable until consummated; accordingly, no expense was recorded related to two-tier stock-based awards until the performance condition became probable of occurring. Awards which contain both service-based and performance conditions were recognized using the accelerated attribution method once the performance condition was probable of occurring. The service-based condition is generally a service period of four years. Upon closing our IPO, we recorded cumulative share-based compensation expense using the accumulated attribution method for two-tier employee stock-based awards for which the service condition had been satisfied at that date. The fair value of options, which vest in accordance with service schedules, is estimated on the date of grant using the Black-Scholes option pricing model. Prior to our IPO, the absence of an active market for our common stock required us to estimate the fair value of our common stock for purposes of granting stock-based awards, including stock options and RSUs, and for determining stock-based compensation expense for the periods presented. We obtained contemporaneous third-party valuations to assist in determining the estimated fair value of our common stock. These contemporaneous third-party valuations used the methodologies, approaches, and assumptions consistent with the American Institute of Certified Public Accountants Practice Guide, Valuation of Privately-Held-Company Equity Securities Issued as Compensation . Expected volatilities are based on historical volatilities of comparable companies when our own historical volatility is not available for a sufficient time period. The expected term of the options is based on the simplified method outlined in the SEC Staff accounting guidance, under which we estimate the term as the average of the option’s contractual term and the option’s weighted average vesting period. The risk-free rate represents the yield on U.S. Treasury bonds with maturity equal to the expected term of the granted option. We account for forfeitures as they occur. All standard stock-based awards outstanding at September 30, 2020 and December 31, 2019 are expected to vest according to their specific schedules. The measurement date for non-employee awards is the date of grant. The compensation expense for non-employees is recognized, without changes in the fair value of the award, in the same period and in the same manner as though we had paid cash for the services, which is typically the vesting period of the respective award. The following two tables summarize our total stock-based compensation expense by award type and where the stock-based compensation expense was recorded in our consolidated statements of operations (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Options $ 1,775 $ 8,907 $ 6,251 $ 11,961 Restricted stock units 5,374 666 15,784 666 Employee stock purchase plan 450 401 1,418 401 Restricted shares 1,897 — 3,830 — Total stock-based compensation $ 9,496 $ 9,974 $ 27,283 $ 13,028 Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Cost of revenue $ 1,099 $ 370 $ 3,184 $ 722 Sales and marketing 3,233 1,358 9,724 2,639 Research and development 2,025 3,067 5,987 3,502 General and administrative 3,139 5,179 8,388 6,165 Total stock-based compensation $ 9,496 $ 9,974 $ 27,283 $ 13,028 We capitalized $0.1 million of stock-based compensation as internal-use software for the three and nine months ended September 30, 2020. Stock Options There were no stock options granted during the three and nine months ended September 30, 2020 and the three months ended September 30, 2019. The fair value of the options granted during the nine months ended September 30, 2019 was estimated at the grant date using the Black-Scholes option-pricing model based on the following weighted average assumptions: Nine Months Ended Expected volatility 43.8%-44.5% Expected term (in years) 6.3 Risk-free interest rate 2.4%-2.5% Expected dividends — A summary of the share option activity under the 2019 Plan for the nine months ended September 30, 2020, is as follows: Time-Based Option Shares Weighted Average Exercise Price Weighted Average Remaining Contractual Life in Years Aggregate Intrinsic Value (in thousands) Outstanding at January 1, 2020 7,847,716 $ 10.67 Options exercised (3,116,393) 9.43 Options cancelled/forfeited (200,341) 11.73 Outstanding at September 30, 2020 4,530,982 $ 11.48 7.2 $ 113,836 Vested and expected to vest as of September 30, 2020 4,530,982 $ 11.48 7.2 $ 113,836 Vested and exercisable as of September 30, 2020 2,322,807 $ 10.56 6.5 $ 60,496 The aggregate intrinsic value of stock options exercised was $65.8 million for the nine months ended September 30, 2020. The total grant-date fair value of stock options vested during the nine months ended September 30, 2020 was $8.1 million. As of September 30, 2020, approximately $9.4 million of unrecognized compensation expense related to our stock options is expected to be recognized over a remaining weighted-average period of 1.8 years. The options exercised for accounting purposes during the nine months ended September 30, 2020 include 52,778 of shares issued to former employees with notes determined to be substantively nonrecourse, which were repaid in full during the period. Restricted Stock Units The service-based condition for RSUs is generally satisfied over four years with a 25% cliff vesting period of one year and ratable quarterly vesting thereafter. The following table sets forth the outstanding RSUs and related activity for the nine months ended September 30, 2020: Restricted Stock Units Weighted Average Grant Date Fair Value Unvested and outstanding at January 1, 2020 503,861 $ 37.57 RSUs granted 1,819,229 33.41 RSUs vested (144,583) 38.04 RSUs forfeited (70,793) 33.83 Unvested and outstanding at September 30, 2020 2,107,714 $ 34.07 As of September 30, 2020, we had $58.9 million of unrecognized stock-based compensation expense related to outstanding RSUs expected to be recognized over a remaining weighted-average period of 3.1 years. Employee Stock Purchase Plan In connection with our IPO in July 2019, our board of directors adopted the ESPP and a total of 750,000 shares of common stock were initially reserved for issuance under the ESPP. The number of shares of common stock available for issuance under the ESPP will be increased on the first day of each calendar year beginning January 1, 2020 and each year thereafter until the ESPP terminates. The number of shares of common stock reserved and available for issuance under the ESPP shall be cumulatively increased by the least of (i) 750,000 shares, (ii) one percent of the number of shares of common stock issued and outstanding on the immediately preceding December 31, and (iii) such lesser number of shares of common stock as determined by the ESPP Administrator. As of January 1, 2020, there were an additional 367,316 shares reserved for issuance under the ESPP. The ESPP generally provides for six-month offering periods, the exception being the first offering period. The offering periods generally start on the first trading day after June 30 and December 31 of each year. The ESPP permits participants to elect to purchase shares of common stock through fixed percentage contributions from eligible compensation during each offering period, not to exceed 15% of the eligible compensation a participant receives during an offering period or accrue at a rate which exceeds $25,000 of the fair value of the stock (determined on the option grant date(s)) for each calendar year. A participant may purchase the lowest of (a) a number of shares of common stock determined by dividing such participant’s accumulated payroll deductions on the exercise date by the option price, (b) 2,500 shares; or (c) such other lesser maximum number of shares as shall have been established by the Administrator in advance of the offering period. Amounts deducted and accumulated by the participant will be used to purchase shares of common stock at the end of each offering period. The purchase price of the shares will be 85% of the lower of the fair value of common stock on the first trading day of each offering period or on the purchase date, except for the first offering period, for which the purchase price will be 85% of the lower of (i) the IPO price or (ii) the fair value of common stock on the purchase date. Participants may end their participation at any time during an offering period and will be paid their accumulated contributions that have not been used to purchase shares of common stock. Participation ends automatically upon termination of employment. The fair value of the purchase right for the ESPP option is estimated on the date of grant using the Black-Scholes model with the following assumptions for the current offering period: Three Months Ended Expected volatility 79.8% Expected term (in months) 6 Risk-free interest rate 0.17% Expected dividends — During the nine months ended September 30, 2020, we issued 97,113 shares under the ESPP, with a weighted-average purchase price per share of $24.79. Total cash proceeds from the purchase of shares under the ESPP during the nine months ended September 30, 2020 were $2.4 million. As of September 30, 2020, a total of 84,116 shares were issuable to employees based on ESPP contribution elections and unrecognized ESPP compensation cost was $0.4 million, which is expected to be recognized over the remaining portion of the current offering period during the three months ending December 31, 2020. As of September 30, 2020, 885,437 shares are available for future issuance under the ESPP. Restricted Shares As part of the Able Health acquisition that closed on February 21, 2020, 179,392 shares of our common stock were issued pursuant to the terms of the acquisition agreement and are a stock-based compensation arrangement subject to a restriction agreement. The vesting of those shares is subject to one year of continuous service by the applicable team members and shall vest on the one-year anniversary of the acquisition closing date. As part of the Vitalware acquisition that closed on September 1, 2020, 203,997 shares of our common stock were issued pursuant to the terms of the acquisition agreement and are a stock-based compensation arrangement subject to a restriction agreement. 75% of these restricted shares will vest on a monthly basis over a term of approximately one year with the remaining 25% vesting on the one-year anniversary of the acquisition closing date. As of September 30, 2020, 12,750 of these restricted shares had vested. As of September 30, 2020, we had $8.1 million of unrecognized stock-based compensation expense related to outstanding restricted shares expected to be recognized over a weighted average period of 0.8 years.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2020
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The tax provision for interim periods is determined using an estimate of our annual effective tax rate, adjusted for discrete items, if any, that arise during the period. Each quarter, we update our estimate of the annual effective tax rate, and if the estimated annual effective tax rate changes, we make a cumulative adjustment in such period. The quarterly tax provision and the estimate of our annual effective tax rate are subject to variation due to several factors, including variability in our loss before income taxes, the mix of jurisdictions to which such income or loss relates, changes in how we conduct business, and tax law developments. For the three months ended September 30, 2020 and 2019, our estimated effective tax rate was (0.1)% and (0.1)%, respectively. For the nine months ended September 30, 2020 and 2019, our estimated effective tax rate was 1.7% and (0.1)%, respectively. The variations between our estimated effective tax rate and the U.S. statutory rate are primarily due to our full valuation allowance. We consider all available evidence to evaluate the recovery of deferred tax assets, including historical levels of income, legislative developments, and risks associated with estimates of future taxable income. We have provided a full valuation allowance for our net deferred tax assets as of September 30, 2020 and December 31, 2019, due to the uncertainty surrounding the future realization of such assets and the cumulative losses we have generated. The income tax benefit of $1.2 million recorded for the nine months ended September 30, 2020, is primarily related to the discrete deferred tax benefit attributable to the release of a portion of the valuation allowance during the first quarter of 2020. The release of valuation allowance is attributable to the acquisition of Able Health, which resulted in deferred tax liabilities that, upon acquisition, allowed us to recognize certain deferred tax assets of $1.3 million that had previously been offset by a valuation allowance. We recognize tax benefits from uncertain tax positions when it is more likely than not, based on the technical merits, that the position will be sustained upon examination. We believe that we have provided adequate reserves for income tax uncertainties in all open tax years. We do not anticipate material changes in the total amount of our unrecognized tax benefits within 12 months of the reporting date. On March 27, 2020, the Coronavirus Aid, Relief and Economic Security (CARES) Act was enacted and signed into U.S. law to provide economic relief to individuals and businesses facing economic hardship as a result of the COVID-19 pandemic. Changes in tax laws or rates are accounted for in the period of enactment. We are continuing to analyze these legislative developments and believe that the income tax provisions of the CARES Act do not have a significant impact on our current taxes, deferred taxes, or uncertain tax positions. The CARES Act also provides for the deferral of an employer’s portion of social security payroll taxes for the remainder of 2020. Under the CARES Act, half of the deferred amount will have to be paid in each of December 2021 and December 2022. We began deferring the social security payroll tax match in April 2020.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2020
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies Lease commitments We lease office space and certain equipment under operating leases that expire between 2020 and 2031. The terms of the leases provide for rental payments on a graduated scale, options to renew the leases ( one Lease payments will be required beginning January 1, 2021, however, we took initial possession of the first 64,910 square feet of the new headquarters in June 2020 to begin leasehold improvements, which resulted in a right-of-use asset and corresponding operating lease liability of $13.0 million, and commencement of operating lease expense. We took possession of an additional 53,297 square feet of the new headquarters lease in August 2020, which resulted in an additional right-of-use asset and corresponding lease liability of $10.8 million. According to the terms of this new lease agreement, our leased square footage will expand between 2022 and 2023 resulting in $2.8 million of additional required future lease payments. We shall have the right to sublease all, or a portion, of this leased office space provided that certain terms and conditions are met. Our operating lease expense for the three months ended September 30, 2020 and 2019 was $1.3 million and $1.1 million, respectively, and the operating lease expense for the nine months ended September 30, 2020 and 2019 was $2.9 million and $2.7 million, respectively. Maturities of lease liabilities under operating leases that had commenced as of September 30, 2020 are as follows (in thousands): Year ending December 31: 2020 (remaining three months) $ 700 2021 3,882 2022 3,425 2023 3,364 2024 3,072 Thereafter 19,975 Total lease payments 34,418 Less: Imputed interest (7,748) Total lease liability $ 26,670 As of September 30, 2020 and December 31, 2019 the weighted-average remaining operating lease term was 10.4 and 2.2 years, respectively, and the weighted-average operating lease discount rate was 5.1% and 5.6%, respectively. Litigation Liabilities for loss contingencies arising from claims, assessments, litigation, fines, penalties, and other sources are recorded when it is probable that a liability has been incurred and the amount can be reasonably estimated. Legal costs incurred in connection with loss contingencies are expensed as incurred. We are involved in legal proceedings from time to time that arise in the normal course of business. As of September 30, 2020 and December 31, 2019, there were no significant outstanding claims against us.

Deferred Revenue and Performanc

Deferred Revenue and Performance Obligations	9 Months Ended
	Sep. 30, 2020
Revenue Recognition and Deferred Revenue [Abstract]
Deferred Revenue and Performance Obligations	Revenue Disaggregation of revenue The following table represents Health Catalyst’s revenue disaggregated by type of arrangement (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Recurring technology $ 27,964 $ 21,160 $ 78,150 $ 61,393 Professional services 19,227 18,263 57,416 50,047 Total revenue $ 47,191 $ 39,423 $ 135,566 $ 111,440 For the three months ended September 30, 2020 and 2019, and for the nine months ended September 30, 2020 and 2019, less than 0.1% of revenue was related to contracts with customers located outside of the United States. Deferred revenue includes advance customer payments and billings in excess of revenue recognized. For the three months ended September 30, 2020 and 2019, 44% and 48%, respectively, of the revenue recognized was included in deferred revenue at the beginning of the period. For the nine months ended September 30, 2020 and 2019, 19% and 18%, respectively, of the revenue recognized was included in deferred revenue at the beginning of the period. Transaction price allocated to the remaining performance obligations three

Related Parties

Related Parties	9 Months Ended
	Sep. 30, 2020
Related Party Transactions [Abstract]
Related Parties	Related Parties We have entered into arrangements with a customer where a member of the customer’s management is currently a member of our board of directors. An executive of a Partners HealthCare affiliate has served on our board of directors since January 2018. We recognized revenue from this related party of $0.7 million and $0.8 million for the three months ended September 30, 2020 and 2019, respectively. We recognized revenue from this related party of $1.8 million and $2.3 million for the nine months ended September 30, 2020 and 2019, respectively. As of September 30, 2020 and December 31, 2019, we had receivables from this related party of $1.2 million and $0.6 million, respectively, and deferred revenue with this related party of $0.7 million and $0.5 million, respectively. As of September 30, 2020 and December 31, 2019, we also had acquisition-related consideration payable to this related party for a prior year asset acquisition. This asset acquisition occurred prior to this entity becoming a related party. The acquisition-related consideration payable to this related party was $1.3 million and $1.2 million as of September 30, 2020 and December 31, 2019, respectively. We have also entered into revenue arrangements with customers that are also our investors. None of these customers hold a significant amount of ownership in our equity interests.

Segments

Segments	9 Months Ended
	Sep. 30, 2020
Segment Reporting [Abstract]
Segments	Segments We operate our business in two operating segments that also represent our reportable segments. Our business is organized based on our technology offerings and professional services. Accordingly, our segments are: • Technology - Our technology segment (Technology) includes our data platform, analytics applications and support services. Technology generates revenues primarily from contracts that are cloud-based subscription arrangements, time-based license arrangements, and maintenance and support fees; and • Professional Services - Our professional services segment (Professional Services) is generally the combination of data and analytics, domain expertise, outsourcing, and implementation services to deliver expertise to our customers to more fully configure and utilize the benefits of our Technology offerings. Revenues and cost of revenues generally are directly attributed to our segments. All segment revenues are from our external customers. Asset and other balance sheet information at the segment level is not reported to our Chief Operating Decision Maker. Segment revenue and Adjusted Gross Profit for the three and nine months ended September 30, 2020 and 2019 were as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Revenue Technology $ 27,964 $ 21,160 $ 78,150 $ 61,393 Professional Services 19,227 18,263 57,416 50,047 Total $ 47,191 $ 39,423 $ 135,566 $ 111,440 Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Adjusted Gross Profit Technology $ 19,115 $ 14,484 $ 53,577 $ 40,986 Professional Services 4,823 6,677 13,624 17,616 Total reportable segments Adjusted Gross Profit 23,938 21,161 67,201 58,602 Less Adjusted Gross Profit reconciling items: Stock-based compensation (1,099) (370) (3,184) (722) Post-acquisition restructuring costs (1) — — — (108) Less other reconciling items: Sales and marketing (14,629) (14,721) (40,618) (35,579) Research and development (13,390) (13,477) (38,539) (33,209) General and administrative (13,297) (11,013) (31,111) (23,333) Depreciation and amortization (4,981) (2,316) (10,952) (6,844) Debt extinguishment costs — — (8,514) (1,670) Interest and other expense, net (3,854) (659) (7,500) (2,924) Net loss before income taxes $ (27,312) $ (21,395) $ (73,217) $ (45,787) ____________________ (1) Post-acquisition restructuring costs included in the Adjusted Gross Profit reconciliation above relate to severance charges following the acquisition of Medicity.

Description of Business and S_2

Description of Business and Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
Basis of presentation	Basis of presentation Our accompanying unaudited condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States (GAAP) and the applicable regulations of the U.S. Securities and Exchange Commission (SEC) regarding interim financial reporting. Certain information and note disclosures normally included in annual financial statements prepared in accordance with GAAP have been condensed or omitted. Therefore, these unaudited condensed consolidated financial statements should be read in conjunction with our audited consolidated financial statements and the related notes thereto as of and for the year ended December 31, 2019 included in our Annual Report on Form 10-K.
Reclassifications	Reclassifications Certain prior year amounts on the condensed consolidated statements of cash flows have been reclassified to conform to the current year presentation. A reclassification was made to separately present the non-cash operating lease expense as a non-cash reconciling adjustment from net loss and the change in the operating lease liabilities due to cash payments as a change in operating assets and liabilities. This net change is not material and does not affect previously reported net cash used in operating activities in the condensed consolidated statements of cash flows. This reclassification had no effect on our other condensed consolidated financial statements for the nine months ended September 30, 2020 and 2019.
Principles of consolidation	Principles of consolidation Our condensed consolidated financial statements include the accounts of Health Catalyst and its wholly-owned subsidiaries. Intercompany balances and transactions have been eliminated.
Use of estimates	Use of estimates The preparation of financial statements in conformity with accounting principles generally accepted in the United States requires us to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. On an on-going basis, we evaluate our estimates, including those related to revenue recognition, provisions for expected credit losses, useful lives of property and equipment, capitalization and estimated useful life of internal-use software and other intangible assets, fair value of financial instruments, deferred tax assets, stock-based compensation, contingent consideration, the period of benefit for deferred contract acquisition costs, the incremental borrowing rate used for operating leases, and tax uncertainties. Actual results could differ from those estimates.
Segment reporting	Segment reporting Operating segments are identified as components of an enterprise about which separate discrete financial information is evaluated by the chief operating decision maker (the CODM) in assessing performance and making decisions regarding resource allocation. We operate our business in two operating segments that also represent our reportable segments. Our segments are (1) technology and (2) professional services. The CODM uses Adjusted Gross Profit (defined as revenue less cost of revenue that excludes depreciation, amortization, stock-based compensation expense, and certain other operating expenses) as the measure of our profit.
Net loss per share	Net loss per share Basic net loss per share is calculated by dividing net loss attributable to common stockholders by the weighted average number of shares of common stock outstanding. Net loss attributable to common stockholders is computed as net loss less accretion of redeemable convertible preferred stock. Diluted net loss per share attributable to common stockholders is calculated by giving effect to all potentially dilutive common stock equivalents outstanding for the period. For purposes of this calculation, stock options, restricted stock units (RSUs), restricted shares, and purchase rights committed under the employee stock purchase plan are considered to be common stock equivalents but have been excluded from the calculation of diluted net loss per share attributable to common stockholders as the effect is antidilutive. Since we have the intent and ability to settle the principal amount of our convertible senior notes in cash and any excess in shares of our common stock, we use the treasury stock method for calculating any potential dilutive effect of the conversion spread on net income (loss) per share, if applicable. The conversion spread has a potentially dilutive impact when the average market price of our common stock for a given period exceeds $30.60 per share. The capped calls are excluded from the calculation of diluted earnings per share, as they would be antidilutive under the treasury stock method.
Revenue recognition	Revenue recognition We recognize revenue in accordance with Accounting Standards Codification Topic 606, Revenue from Contracts with Customers (Topic 606) . We derive our revenues primarily from technology subscriptions and professional services. We determine revenue recognition by applying the following steps: • Identification of the contract, or contracts, with a customer; • Identification of the performance obligations in the contract; • Determination of the transaction price; • Allocation of the transaction price to the performance obligations in the contract; and • Recognition of revenue when, or as, we satisfy the performance obligation. We recognize revenue net of any taxes collected from customers and subsequently remitted to governmental authorities. Technology revenue Technology revenue primarily consists of subscription fees charged to customers for access to use our technology. We provide customers access to our technology through either an all-access or limited-access, modular subscription. The majority of our subscription arrangements are cloud-based and do not provide customers the right to take possession of the technology or contain a significant penalty if the customer were to take possession of the technology. Revenue from cloud-based subscriptions is recognized ratably over the contract term beginning on the date that the service is made available to the customer. Most of our DOS subscription contracts have up to a three-year term, of which the vast majority are terminable after one year upon 90 days’ notice. Subscriptions that allow the customer to take software on-premise without significant penalty are treated as time-based licenses. These arrangements generally include access to technology, access to unspecified future products, and maintenance and support. Revenue for upfront access to our technology library is recognized at a point in time when the technology is made available to the customer. Revenue for access to unspecified future products included in time-based license subscriptions is recognized ratably over the contract term beginning on the date that the access is made available to the customer. We also have certain perpetual license arrangements. Revenue from these arrangements is recognized at a point in time upon delivery of the software. Technology revenue also includes maintenance and support revenue which generally includes bug fixes, updates, and support services. Revenue related to maintenance and support is recognized over the contract term beginning on the date that the service is made available to the customer. Professional services revenue Professional services revenue primarily includes data and analytics services, domain expertise services, outsourcing services, and implementation services. Professional services arrangements typically include a fee for making full-time equivalent (FTE) services available to our customers on a monthly basis. FTE services generally consist of a blend of analytic engineers, analysts, and data scientists based on the domain expertise needed to best serve our customer. Professional services are typically considered distinct from the technology offerings and revenue is generally recognized as the service is provided using the “right to invoice” practical expedient. Contracts with multiple performance obligations Many of our contracts include multiple performance obligations. We account for performance obligations separately if they are capable of being distinct within the context of the contract. In these circumstances, the transaction price is allocated to separate performance obligations on a relative standalone selling price basis. We determine standalone selling prices based on the observable price a good or service is sold for separately when available. In cases where standalone selling prices are not directly observable, based on information available, we utilize the expected cost plus a margin, adjusted market assessment, or residual estimation method. We consider all information available including our overall pricing objectives, market conditions, and other factors, which may include customer demographics and the types of users. Standalone selling prices are not directly observable for our all-access and limited-access technology arrangements, which are composed of cloud-based subscriptions, time-based licenses, and perpetual licenses. For these technology arrangements, we use the residual estimation method due to a limited number of standalone transactions and/or prices that are highly variable. Variable consideration We have also entered into at-risk and shared savings arrangements with certain customers whereby we receive variable consideration based on the achievement of measurable improvements which may include cost savings or performance against metrics. For these arrangements, we estimate revenue using the most likely amount that we will receive. Estimates are based on our historical experience and best judgment at the time to the extent it is probable that a significant reversal of revenue recognized will not occur. Due to the nature of our arrangements, certain estimates may be constrained until the uncertainty is further resolved. Contract balances Deferred Costs We capitalize sales commissions, and associated fringe costs, such as payroll taxes, paid to direct sales personnel and other incremental costs of obtaining contracts with customers, provided we expect to recover those costs. We determine that costs should be deferred based on our sales compensation plans when the commissions are incremental and would not have occurred absent the customer contract. As of September 30, 2020, $0.4 million of deferred commissions are expected to be amortized within the next 12 months and are included in prepaid expenses and other assets on the consolidated balance sheets. The remaining $1.1 million of deferred commissions are included in non-current other assets. Commissions paid upon the initial acquisition of a contract are amortized on a straight-line basis over an estimated period of benefit of four years. Amortization is recognized on a straight-line basis commensurate with the pattern of revenue recognition. The period of benefit was estimated by considering factors such as estimated average customer life, the rate of technological change in our subscription service, and the impact of competition in our industry. As our average customer life significantly exceeded the rate of change in our technology, we concluded that the rate of change in the technology underlying our subscription service was the most significant factor in determining the period of benefit for which the asset relates. In evaluating the rate of change in our technology, we considered the competition in our industry, our commitment to continuous innovation, and the frequency of product, platform, and technology updates. We determined that the impact of competition in our industry is reflected in the period of benefit through the rate of technological change. Amortization of deferred contract acquisition costs is included within sales and marketing expense in the condensed consolidated statements of operations. We defer certain costs to fulfill a contract when the costs are expected to be recovered, are directly related to in-process contracts and enhance resources that will be used in satisfying performance obligations in the future. These deferred fulfillment costs primarily consist of employee compensation incurred as part of the implementation of new contracts. As of September 30, 2020 and December 31, 2019, $0.3 million and $0.9 million, respectively, of deferred fulfillment costs were included in prepaid expenses and other assets on the condensed consolidated balance sheets. Amortization of deferred fulfillment costs is included within cost of revenue in the condensed consolidated statements of operations. We periodically review these deferred costs to determine whether events or changes in circumstances have occurred that could impact the period of benefit. There were no impairment losses recorded during the periods presented. Cost of revenue, excluding depreciation and amortization Cost of technology revenue primarily consists of costs associated with hosting and supporting our technology, including third-party cloud computing and hosting costs, contractor costs, and salary and related personnel costs for our cloud services and support teams. Cost of professional services revenue primarily consists of salary and related personnel costs, travel-related costs, and independent contractor costs. Cost of revenue excludes costs related to depreciation and amortization.
Cash and cash equivalents	Cash and cash equivalents We consider all highly liquid investments purchased with a remaining maturity of three months or less at the time of acquisition to be cash equivalents.
Short-term investments	Short-term investmentsOur investment policy limits investments to highly-rated instruments that mature in less than 12 months. We classify our short-term investments as available for sale.
Accounts receivable	Accounts receivableAccounts receivable are non-interest bearing and are recorded at the original invoiced amount less an allowance for credit losses based on the probability of future collections. We adopted ASU 2016-13 effective January 1, 2020. ASU 2016-13 replaces the existing incurred loss impairment model with an expected loss model which requires the use of forward-looking information to calculate credit loss estimates, which results in earlier recognition of credit losses. The allowance is based on our estimate of expected credit losses for outstanding trade accounts receivables and unbilled receivables. We determine expected credit losses based on historical write-off experience, an analysis of the aging of outstanding receivables, customer payment patterns, the establishment of specific reserves for customers in an adverse financial condition, and our expectations of changes in macro-economic conditions, including the current COVID-19 pandemic, that may impact the collectability of outstanding receivables. We reassess the adequacy of the allowance for credit losses each reporting period.
Property and equipment	Property and equipment Property and equipment are stated at historical cost less accumulated depreciation. Repairs and maintenance costs that do not extend the useful life or improve the related assets are expensed as incurred. Depreciation and amortization is computed using the straight-line method over the estimated useful lives of the assets. The estimated useful life of each asset category is as follows: Computer equipment 2-3 years Furniture and fixtures 3 years Leasehold improvements Lesser of lease term or estimated useful life Computer software 2-3 years Capitalized internal-use software costs 2-3 years
Intangible assets	Intangible assets Intangible assets include developed technologies, customer relationships, customer contract backlog, and trademarks that were acquired in business combinations and asset acquisitions. Intangible assets also include the purchase of third-party computer software. The intangible assets are amortized using the straight-line method over the assets’ estimated useful lives. The estimated useful life of each asset category is as follows: Developed technologies 2-10 years Customer relationships and contract backlog 2-7 years Computer software licenses 2-5 years Trademarks 2-5 years
Goodwill	Goodwill We continually evaluate potential acquisitions that either strategically fit within our existing portfolio or expand our portfolio into new product lines or adjacent markets. We have completed a number of acquisitions that have been accounted for as business combinations under ASC 805, Business Combinations , and have resulted in the recognition of goodwill in our condensed consolidated financial statements. This goodwill includes the know-how of the assembled workforce, the ability of the workforce to further improve technology and product offerings, customer relationships, and the expected cash flows resulting from these efforts. Goodwill may also include expected synergies resulting from the complementary strategic fit these businesses bring to existing operations. We record goodwill as the difference between the aggregate consideration paid for a business combination and the fair value of the identifiable net tangible and intangible assets acquired. Goodwill is assessed for impairment annually or more frequently if indicators of impairment are present or circumstances suggest that impairment may exist. As of January 1, 2020, we adopted ASU 2017-04, which simplifies the goodwill impairment test by eliminating the second step from the goodwill impairment test. The first step of the goodwill impairment test compares the fair value of the reporting unit with its carrying amount, including goodwill. If the fair value of the reporting unit exceeds its carrying amount, the goodwill of the reporting unit is not considered impaired. If the carrying amount of the reporting unit exceeds its fair value, we would recognize an impairment charge for the amount by which the carrying amount exceeds the reporting unit’s fair value.
Business combinations	Business combinations
Contingent consideration liabilities	Contingent consideration liabilities Our acquisition consideration in business combinations may include an estimate for contingent consideration that will be paid if certain earn-out performance targets are met. The resulting contingent consideration liabilities are categorized as a Level 3 fair value measurement because we estimate projections during the earn-out period utilizing unobservable inputs, including various potential pay-out scenarios. Changes to the unobservable inputs could have a material impact on our condensed consolidated financial statements. We value the expected contingent consideration and the corresponding liabilities using the Monte Carlo method based on estimates of potential pay-out scenarios. Probabilities are applied to each potential scenario and the resulting values are discounted using a rate that considers weighted average cost of capital as well as a specific risk premium associated with the riskiness of the earn-out itself, the related projections, and volatility in the fair value of our common stock.
Advertising cost	Advertising costs
Development cost and internal-use software	Development costs and internal-use software For technology products that are developed to be licensed externally, we determined that technological feasibility is reached shortly before the products are ready for general release. Any costs associated with software development between the time technological feasibility is reached and general release are inconsequential. We capitalize certain development costs incurred in connection with our internal-use software. These capitalized costs are primarily related to the software platforms that are hosted by us and accessed by our customers on a subscription basis. Costs incurred in the preliminary stages of development are expensed as incurred as research and development costs. Once an application has reached the development stage, internal and external costs, if direct and incremental, are capitalized until the software is substantially complete and ready for its intended use. We also capitalize costs related to specific upgrades and enhancements when it is probable the expenditures will result in additional functionality. Capitalized costs are recorded as part of property and equipment. Maintenance and training costs are expensed as incurred. Internal-use software is amortized on a straight-line basis over its estimated useful life.
Stock-based compensation	Stock-based compensation Stock-based awards, including stock options and RSUs, are measured and recognized in our condensed consolidated financial statements based on the fair value of the award on the grant date. For awards subject to performance conditions, we record expense when the performance condition becomes probable. We record forfeitures of stock-based awards as the actual forfeitures occur. We estimate the fair value of stock option awards on the grant date using the Black-Scholes option pricing model. We have issued two types of employee stock-based awards, standard and two-tier. Our standard stock-based awards vest solely on a service-based condition. For these awards, we recognize stock-based compensation expense on a straight-line basis over the vesting period. Two-tier employee stock-based awards, contain both a service-based condition and performance condition, defined as the earlier of (i) an acquisition or change in control of the company or (ii) upon the occurrence of an initial public offering by the Company. A change in control event and effective registration event are not deemed probable until consummated; accordingly, no expense was recorded related to two-tier stock-based awards until the performance condition became probable of occurring. Awards that contain both service-based and performance conditions were recognized using the accelerated attribution method once the performance condition is probable of occurring. The service-based condition is generally a service period of four years. Stock-based compensation expense related to purchase rights issued under the 2019 Health Catalyst Employee Stock Purchase Plan (ESPP) is based on the Black-Scholes option-pricing model fair value of the estimated number of awards as of the beginning of the offering period. Stock-based compensation expense is recognized using the straight-line method over the offering period. The compensation expense for non-employees is recognized, without changes in the fair value of the award, in the same period and in the same manner as though we had paid cash for the services, which is typically the vesting period of the respective award.
Income taxes	Income taxes Deferred income tax balances are accounted for using the asset and liability method and reflect the effects of temporary differences between the financial reporting and tax bases of our assets and liabilities using enacted tax rates expected to apply when taxes are actually paid or recovered. In addition, deferred tax assets and liabilities are recorded for net operating loss (NOL) and credit carryforwards. A valuation allowance is provided against deferred tax assets unless it is more likely than not that they will be realized based on all available positive and negative evidence. Such evidence includes, but is not limited to, recent cumulative earnings or losses, expectations of future taxable income by taxing jurisdiction, and the carry-forward periods available for the utilization of deferred tax assets. We use a two-step approach to recognize and measure uncertain income tax positions. The first step is to evaluate the tax position for recognition by determining if the weight of available evidence indicates it is more likely than not that the position will be sustained upon audit. The second step is to measure the tax benefit as the largest amount, which is more than 50% likely of being realized upon ultimate settlement. We do not accrue interest and penalties related to unrecognized tax benefits within the provision for income taxes because we have NOLs. Significant judgment is required to evaluate uncertain tax positions. Although we believe that we have adequately reserved for our uncertain tax positions, we can provide no assurance that the final tax outcome of these matters will not be materially different. We evaluate our uncertain tax positions on a regular basis and evaluations are based on a number of factors, including changes in facts and circumstances, changes in tax law, such as the Tax Cuts and Jobs Act of 2017, correspondence with tax authorities during the course of an audit, and effective settlement of audit issues. To the extent that the final tax outcome of these matters is different than the amounts recorded, such differences will affect the provision for income taxes in the period in which such determination is made and could have a material impact on our financial condition and results of operations.
Fair value of financial instruments	Fair value of financial instruments The carrying amounts reported in our condensed consolidated balance sheets for cash, receivables, accounts payable, and current accrued expenses approximate fair values because of the immediate or short-term maturity of these financial instruments. The carrying value of acquisition-related consideration payable, operating lease liabilities, and long-term debt approximate fair value based on interest rates available for debt with similar terms at September 30, 2020 and December 31, 2019. Money market funds and short-term investments are measured at fair value on a recurring basis. Our contingent consideration liabilities are measured at fair value on a recurring basis based primarily on significant inputs not observable in the market. Fair value is estimated by applying the following hierarchy, which prioritizes the inputs used to measure fair value into three levels and bases the categorization within the hierarchy upon the lowest level of input that is available and significant to the fair value measurement: • Level 1- Quoted prices in active markets for identical assets or liabilities. • Level 2- Observable inputs other than quoted prices in active markets for identical assets and liabilities, quoted prices for identical or similar assets or liabilities in inactive markets, or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities. • Level 3- Inputs that are generally unobservable and typically reflect management’s estimate of assumptions that market participants would use in pricing the asset or liability. All of our financial instruments are valued using quoted prices in active markets or based on other observable inputs. For Level 2 securities, we use a third-party pricing service which provides documentation on an ongoing basis that includes, among other things, pricing information with respect to reference data, methodology, inputs summarized by asset class, pricing application, and corroborative information. Our contingent consideration liabilities are categorized as a Level 3 fair value measurement because we estimate projections during the earn out period utilizing various potential pay-out scenarios.
Leases	Leases We determine if an arrangement is a lease and determine the lease classification as of the lease commencement date. Operating leases are included in operating lease right-of-use (ROU) assets, operating lease liabilities, and operating lease liabilities, net of current portion in our condensed consolidated balance sheets. We have adopted the short-term lease recognition exemption policy. All of our leasing commitments are classified either as operating leases or otherwise qualify as short-term leases with lease terms of 12 months or less. ROU assets represent our right to use an underlying asset for the lease term and lease liabilities represent our obligation to make lease payments arising from the lease. Operating lease ROU assets and liabilities are recognized at commencement date based on the present value of lease payments over the lease term. As our lease contracts do not provide an implicit rate, we use our incremental borrowing rate based on the information available at commencement date to determine the present value of lease payments. The operating lease ROU asset also includes any lease payments made and excludes lease executory costs. Our lease terms may include options to extend or terminate the lease when it is reasonably certain that we will exercise the applicable option. Lease expense for lease payments is recognized on a straight-line basis over the lease term. We do not have lease agreements that contain non-lease components, which generally would be accounted for separately.
Accounting pronouncements adopted and Recent accounting pronouncements not yet adopted	Accounting pronouncements adopted Goodwill impairment In January 2017, the Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) 2017-04, Intangibles-Goodwill and Other - Simplifying the Test for Goodwill Impairment (Topic 350) , that simplifies how an entity is required to test goodwill for impairment by eliminating the second step of the impairment test. The first step measures a goodwill impairment loss by comparing the fair value of a reporting unit to the carrying amount. If the carrying amount of the reporting unit exceeds its fair value, the carrying amount of goodwill is reduced by the excess reporting unit carrying amount up to the carrying amount of the goodwill. We adopted ASU 2017-04 as of January 1, 2020. The guidance applies to our reporting requirements in performing goodwill impairment testing; however, the adoption of this guidance did not have an impact on our condensed consolidated financial statements and related disclosures. Fair value measurements In August 2018, the FASB issued ASU 2018-13, Fair Value Measurement (Topic 820), Disclosure Framework - Changes to the Disclosure Requirements for Fair Value Measurement , which eliminates certain disclosure requirements for fair value measurements for all entities, requires public entities to disclose certain new information prospectively, including the ranges used to develop significant unobservable inputs for Level 3 fair value measurements, and modifies some disclosure requirements. We adopted ASU 2018-13 as of January 1, 2020. The adoption of this standard did not have a material impact on our condensed consolidated financial statements and related disclosures. Credit losses In June 2016, the FASB issued ASU 2016-13, Financial Instruments - Credit Losses (Topic 326) , which required the measurement and recognition of expected credit losses for certain financial instruments, which includes our accounts receivable and available-for-sale debt securities. ASU 2016-13 replaces the existing incurred loss impairment model with an expected loss model which requires the use of forward-looking information to calculate credit loss estimates, which results in earlier recognition of credit losses. We adopted ASU 2016-13 effective January 1, 2020. The adoption of the standard did not have a material impact on our condensed consolidated financial statements. The adoption adjustment was recorded to our accumulated deficit, as seen in our condensed consolidated statements of redeemable convertible preferred stock and stockholders’ equity. Implementation Costs Incurred in a Cloud Computing Arrangement In August 2018, the FASB issued ASU 2018-15, Intangibles — Goodwill and Other — Internal-Use Software (Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract . ASU 2018-15 aligns the requirements for capitalizing implementation costs in a cloud computing arrangement service contract with the requirements for capitalizing implementation costs incurred for an internal-use software license. We prospectively adopted ASU 2018-15 effective January 1, 2020. The adoption of this standard did not have a material impact on our condensed consolidated financial statements and related disclosures. Recent accounting pronouncements not yet adopted Accounting for income taxes In December 2019, the FASB issued ASU 2019-12, Income Taxes (Topic 740) - Simplifying the Accounting for Income Taxes , which simplifies the accounting for income taxes, eliminates certain exceptions within Topic 740, and clarifies certain aspects of the current guidance to promote consistency among reporting entities. The new standard is effective for fiscal years beginning after December 15, 2021. Most amendments within the standard are required to be applied on a prospective basis, while certain amendments must be applied on a retrospective or modified retrospective basis. We are currently evaluating the impacts the provisions of this standard will have on our condensed consolidated financial statements and related disclosures. Accounting for convertible instruments In August 2020, the FASB issued ASU 2020-06, Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity's Own Equity (Subtopic 815-40)—Accounting For Convertible Instruments and Contracts in an Entity's Own Equity . The new standard simplifies accounting for convertible instruments by removing major separation models required under current GAAP. Consequently, more convertible debt instruments will be reported as a single liability instrument with no separate accounting for embedded conversion features. The new standard removes certain settlement conditions that previously required derivative accounting. Consequently, more equity contracts will be permitted to qualify for the derivative scope exception.

Description of Business and S_3

Description of Business and Summary of Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
Schedule of allowance for accounts receivable	The following table presents a rollforward of the allowance for credit losses (in thousands): Allowance for Credit Losses on Accounts Receivable Balance at January 1, 2020 $ 534 Current period provision for expected credit losses 822 Less: Write-offs, net of recoveries (170) Balance at September 30, 2020 $ 1,186
Schedule of property and equipment, useful life	The estimated useful life of each asset category is as follows: Computer equipment 2-3 years Furniture and fixtures 3 years Leasehold improvements Lesser of lease term or estimated useful life Computer software 2-3 years Capitalized internal-use software costs 2-3 years Property and equipment consisted of the following (in thousands): As of As of 2020 2019 Computer equipment $ 7,794 $ 7,951 Leasehold improvements 4,182 2,234 Furniture and fixtures 1,041 1,030 Capitalized internal-use software costs 2,617 1,866 Computer software 958 972 Capital lease equipment 37 37 Total property and equipment 16,629 14,090 Less: accumulated depreciation (11,310) (9,795) Property and equipment, net $ 5,319 $ 4,295
Schedule of intangible asset, useful life	The estimated useful life of each asset category is as follows: Developed technologies 2-10 years Customer relationships and contract backlog 2-7 years Computer software licenses 2-5 years Trademarks 2-5 years As of September 30, 2020, intangible assets consisted of the following (in thousands): Gross Accumulated Amortization Net Developed technologies $ 69,729 $ (21,911) $ 47,818 Customer relationships and contracts 57,764 (4,444) 53,320 Computer software licenses 7,291 (4,115) 3,176 Trademarks 1,700 (88) 1,612 Total intangible assets $ 136,484 $ (30,558) $ 105,926 As of December 31, 2019, intangible assets consisted of the following (in thousands): Gross Accumulated Amortization Net Developed technologies $ 36,129 $ (16,548) $ 19,581 Customer relationships and contracts 4,164 (2,773) 1,391 Computer software licenses 7,114 (2,576) 4,538 Trademarks 100 (75) 25 Total intangible assets $ 47,507 $ (21,972) $ 25,535

Business Combinations (Tables)

Business Combinations (Tables)	9 Months Ended
	Sep. 30, 2020
Business Combinations [Abstract]
Schedule of recognized identified assets acquired and liabilities assumed	The following table summarizes the acquisition-date fair value of consideration transferred and the identifiable assets purchased and liabilities assumed as part of our acquisition of Able Health (in thousands): Assets acquired: Accounts receivable $ 633 Prepaid expenses and other assets 57 Developed technologies 7,500 Customer relationships 600 Trademarks 100 Total assets acquired 8,890 Less liabilities assumed: Accounts payable and other current liabilities 91 Deferred revenue 762 Net deferred tax liabilities 1,280 Total liabilities assumed 2,133 Total assets acquired, net 6,757 Goodwill 14,725 Total consideration transferred, net of cash acquired $ 21,482 The following table summarizes the acquisition-date fair value of consideration transferred and the identifiable assets purchased and liabilities assumed as part of our acquisition of Healthfinch (in thousands): Assets acquired: Accounts receivable $ 1,408 Prepaid expenses and other assets 347 Developed technologies 8,100 Customer relationships and contract backlog 10,000 Trademarks 200 Total assets acquired 20,055 Less liabilities assumed: Accounts payable and other current liabilities 408 Deferred revenue 2,100 Total liabilities assumed 2,508 Total assets acquired, net 17,547 Goodwill 32,960 Total consideration transferred, net of cash acquired $ 50,507 The following table summarizes the acquisition-date fair value of consideration transferred and the identifiable assets purchased and liabilities assumed as part of our acquisition of Vitalware (in thousands): Assets acquired: Accounts receivable $ 3,220 Prepaid expenses and other assets 469 Developed technologies 18,000 Customer relationships and contract backlog 43,000 Trademarks 1,400 Total assets acquired 66,089 Less liabilities assumed: Accounts payable and other current liabilities 766 Deferred revenue 2,589 Total liabilities assumed 3,355 Total assets acquired, net 62,734 Goodwill 56,443 Total consideration transferred, net of cash acquired $ 119,177
Schedule of unaudited pro forma information as if the acquisition of medicity had occurred on January 1, 2017	The following table reflects our unaudited pro forma combined results of operations for the three and nine months ended September 30, 2020 and 2019 as if the acquisitions of Able Health, Healthfinch, and Vitalware had taken place on January 1, 2019: Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Total pro forma revenues $ 52,525 $ 44,745 $ 154,363 $ 123,998 Pro forma net loss (27,159) (28,828) (83,233) (69,303)

Revenue (Tables)

Revenue (Tables)	9 Months Ended
	Sep. 30, 2020
Revenue from Contract with Customer [Abstract]
Schedule of revenue disaggregated by type of arrangement	The following table represents Health Catalyst’s revenue disaggregated by type of arrangement (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Recurring technology $ 27,964 $ 21,160 $ 78,150 $ 61,393 Professional services 19,227 18,263 57,416 50,047 Total revenue $ 47,191 $ 39,423 $ 135,566 $ 111,440

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	9 Months Ended
	Sep. 30, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of goodwill by reporting unit	Goodwill by reporting unit is as follows (in thousands): As of As of 2020 2019 Technology $ 107,040 $ 2,912 Professional services 782 782 Total goodwill $ 107,822 $ 3,694
Schedule of intangible assets	The estimated useful life of each asset category is as follows: Developed technologies 2-10 years Customer relationships and contract backlog 2-7 years Computer software licenses 2-5 years Trademarks 2-5 years As of September 30, 2020, intangible assets consisted of the following (in thousands): Gross Accumulated Amortization Net Developed technologies $ 69,729 $ (21,911) $ 47,818 Customer relationships and contracts 57,764 (4,444) 53,320 Computer software licenses 7,291 (4,115) 3,176 Trademarks 1,700 (88) 1,612 Total intangible assets $ 136,484 $ (30,558) $ 105,926 As of December 31, 2019, intangible assets consisted of the following (in thousands): Gross Accumulated Amortization Net Developed technologies $ 36,129 $ (16,548) $ 19,581 Customer relationships and contracts 4,164 (2,773) 1,391 Computer software licenses 7,114 (2,576) 4,538 Trademarks 100 (75) 25 Total intangible assets $ 47,507 $ (21,972) $ 25,535

Property and Equipment (Tables)

Property and Equipment (Tables)	9 Months Ended
	Sep. 30, 2020
Property, Plant and Equipment [Abstract]
Property and equipment	The estimated useful life of each asset category is as follows: Computer equipment 2-3 years Furniture and fixtures 3 years Leasehold improvements Lesser of lease term or estimated useful life Computer software 2-3 years Capitalized internal-use software costs 2-3 years Property and equipment consisted of the following (in thousands): As of As of 2020 2019 Computer equipment $ 7,794 $ 7,951 Leasehold improvements 4,182 2,234 Furniture and fixtures 1,041 1,030 Capitalized internal-use software costs 2,617 1,866 Computer software 958 972 Capital lease equipment 37 37 Total property and equipment 16,629 14,090 Less: accumulated depreciation (11,310) (9,795) Property and equipment, net $ 5,319 $ 4,295

Short-term Investments (Tables)

Short-term Investments (Tables)	9 Months Ended
	Sep. 30, 2020
Investments, Debt and Equity Securities [Abstract]
Schedule of cash equivalents and short-term investments measured at fair value	The following table summarizes, by major security type, our cash equivalents and short-term investments that are measured at fair value on a recurring basis (in thousands) as of September 30, 2020: Amortized Cost Unrealized Gains Unrealized Losses Fair Value Cash equivalents Short-term Investments Money market funds $ 100,913 $ — $ — $ 100,913 $ 100,913 $ — U.S. Treasury notes 49,571 23 — 49,594 — 49,594 Commercial paper 51,883 — — 51,883 — 51,883 Corporate bonds 59,364 30 (1) 59,393 — 59,393 Asset-backed securities 3,027 1 — 3,028 — 3,028 Total $ 264,758 $ 54 $ (1) $ 264,811 $ 100,913 $ 163,898 The following table summarizes, by major security type, our cash equivalents and short-term investments that are measured at fair value on a recurring basis (in thousands) as of December 31, 2019: Amortized Cost Unrealized Gains Unrealized Losses Fair Value Cash equivalents Short-term Investments Money market funds $ 17,175 $ — $ — $ 17,175 $ 17,175 $ — US treasury notes 58,130 34 — 58,164 — 58,164 Commercial paper 46,973 — — 46,973 — 46,973 Corporate bonds 64,978 27 (5) 65,000 — 65,000 Asset-backed securities 40,090 18 — 40,108 — 40,108 Total $ 227,346 $ 79 $ (5) $ 227,420 $ 17,175 $ 210,245

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)	9 Months Ended
	Sep. 30, 2020
Fair Value Disclosures [Abstract]
Fair value, assets measured on recurring basis	Assets and liabilities measured at fair value on a recurring basis as of September 30, 2020 were as follows (in thousands): September 30, 2020 Level 1 Level 2 Level 3 Total Money market funds $ 100,913 $ — $ — $ 100,913 U.S. Treasury notes 49,594 — — 49,594 Commercial paper — 51,883 — 51,883 Corporate bonds — 59,393 — 59,393 Asset-backed securities — 3,028 — 3,028 Contingent consideration — — (16,172) (16,172) Total $ 150,507 $ 114,304 $ (16,172) $ 248,639 Assets measured at fair value on a recurring basis as of December 31, 2019 were as follows (in thousands): December 31, 2019 Level 1 Level 2 Level 3 Total Money market funds $ 17,175 $ — $ — $ 17,175 U.S. Treasury notes 58,164 — — 58,164 Commercial paper — 46,973 — 46,973 Corporate bonds — 65,000 — 65,000 Asset-backed securities $ — $ 40,108 $ — $ 40,108 Total $ 75,339 $ 152,081 $ — $ 227,420
Liabilities measured on recurring basis, unobservable input reconciliation	The following table sets forth a summary of the changes in the estimated fair value of the contingent consideration liabilities, which is measured at fair value on a recurring basis using significant unobservable inputs (in thousands): Fair Value Measurements Using Significant Unobservable Inputs (Level 3) Balance at December 31, 2019 $ — Initial contingent consideration liabilities from acquisitions (see Note 2) 17,176 Change in fair value of contingent consideration liabilities (1,004) Balance at September 30, 2020 $ 16,172

Accrued liabilities (Tables)

Accrued liabilities (Tables)	9 Months Ended
	Sep. 30, 2020
Payables and Accruals [Abstract]
Schedule of accrued liabilities	As of September 30, 2020 and December 31, 2019, accrued liabilities consisted of the following (in thousands): As of As of 2020 2019 Accrued compensation and benefit expenses $ 7,041 $ 4,278 Interest payable 2,636 — Other accrued liabilities 4,384 4,666 Total accrued liabilities $ 14,061 $ 8,944

Convertible Senior Notes and _2

Convertible Senior Notes and Credit Facilities (Tables)	9 Months Ended
	Sep. 30, 2020
Debt Disclosure [Abstract]
Schedule of convertible debt	The net carrying value of the liability component of the Notes was as follows (in thousands): September 30, 2020 Principal $ 230,000 Less: Unamortized debt discount (58,763) Less: Unamortized issuance costs (5,037) Net carrying amount $ 166,200 The net carrying value of the equity component of the Notes was as follows (in thousands): September 30, 2020 Proceeds allocated to the conversion option (debt discount) $ 63,270 Less: Issuance costs (2,057) Net carrying amount $ 61,213 The interest expense recognized related to the Notes was as follows (in thousands): Three Months Ended Nine Months Ended Contractual interest expense $ 1,437 $ 2,635 Amortization of debt issuance costs and discount 2,720 4,931 Total $ 4,157 $ 7,566 Based on the closing price of our common stock of $36.60 on September 30, 2020, the if-converted value of the Notes was $45.1 million more than their respective principal amount.
Schedule of term credit facilities	As of December 31, 2019, our term credit facilities consisted of the following, excluding unamortized debt discount and issue costs of $1.8 million (in thousands): Balance Remaining Capacity Interest Rate Basis Rate OrbiMed term loan $ 50,000 $ 30,000 10.00% Higher of LIBOR plus 7.5% and 10.0% SVB revolving line of credit — 5,000 5.25% Prime plus 0.50% Total credit facilities 50,000 $ 35,000 Less: Current portion of credit facilities — Credit facilities, less current portion $ 50,000

Net Loss Per Share (Tables)

Net Loss Per Share (Tables)	9 Months Ended
	Sep. 30, 2020
Earnings Per Share [Abstract]
Schedule of the calculation of basic and diluted net loss per share attributable to common stockholders	The following table presents the calculation of basic and diluted net loss per share attributable to common stockholders (in thousands, except share and per share amounts): Three Months Ended Nine Months Ended 2020 2019 2020 2019 Numerator: Net loss attributable to common stockholders $ (27,326) $ (39,586) $ (71,999) $ (226,656) Denominator: Weighted-average number of shares used in calculating net loss per share attributable to common stockholders, basic and diluted 40,292,380 28,222,555 38,517,272 12,749,903 Net loss per share attributable to common stockholders, basic and diluted $ (0.68) $ (1.40) $ (1.87) $ (17.78)
Schedule of share totals with a potentially dilutive impact	The following table contains share totals with a potentially dilutive impact: As of September 30, 2020 2019 Common stock options 4,530,982 7,923,437 Restricted stock units 2,107,714 257,278 Shares related to convertible senior notes 743,665 — Restricted shares 370,639 — Employee stock purchase plan 84,166 138,470 Total potentially dilutive securities 7,837,166 8,319,185

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2020
Share-based Payment Arrangement [Abstract]
Schedule of stock-based compensation expense	The following two tables summarize our total stock-based compensation expense by award type and where the stock-based compensation expense was recorded in our consolidated statements of operations (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Options $ 1,775 $ 8,907 $ 6,251 $ 11,961 Restricted stock units 5,374 666 15,784 666 Employee stock purchase plan 450 401 1,418 401 Restricted shares 1,897 — 3,830 — Total stock-based compensation $ 9,496 $ 9,974 $ 27,283 $ 13,028 Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Cost of revenue $ 1,099 $ 370 $ 3,184 $ 722 Sales and marketing 3,233 1,358 9,724 2,639 Research and development 2,025 3,067 5,987 3,502 General and administrative 3,139 5,179 8,388 6,165 Total stock-based compensation $ 9,496 $ 9,974 $ 27,283 $ 13,028
Schedule of share-based payment award, stock options, valuation assumptions	The fair value of the options granted during the nine months ended September 30, 2019 was estimated at the grant date using the Black-Scholes option-pricing model based on the following weighted average assumptions: Nine Months Ended Expected volatility 43.8%-44.5% Expected term (in years) 6.3 Risk-free interest rate 2.4%-2.5% Expected dividends —
Schedule of information related to stock options	A summary of the share option activity under the 2019 Plan for the nine months ended September 30, 2020, is as follows: Time-Based Option Shares Weighted Average Exercise Price Weighted Average Remaining Contractual Life in Years Aggregate Intrinsic Value (in thousands) Outstanding at January 1, 2020 7,847,716 $ 10.67 Options exercised (3,116,393) 9.43 Options cancelled/forfeited (200,341) 11.73 Outstanding at September 30, 2020 4,530,982 $ 11.48 7.2 $ 113,836 Vested and expected to vest as of September 30, 2020 4,530,982 $ 11.48 7.2 $ 113,836 Vested and exercisable as of September 30, 2020 2,322,807 $ 10.56 6.5 $ 60,496
Schedule of outstanding RSUs and related activity	The following table sets forth the outstanding RSUs and related activity for the nine months ended September 30, 2020: Restricted Stock Units Weighted Average Grant Date Fair Value Unvested and outstanding at January 1, 2020 503,861 $ 37.57 RSUs granted 1,819,229 33.41 RSUs vested (144,583) 38.04 RSUs forfeited (70,793) 33.83 Unvested and outstanding at September 30, 2020 2,107,714 $ 34.07
Schedule of the purchase right for the ESPP option assumptions	The fair value of the purchase right for the ESPP option is estimated on the date of grant using the Black-Scholes model with the following assumptions for the current offering period: Three Months Ended Expected volatility 79.8% Expected term (in months) 6 Risk-free interest rate 0.17% Expected dividends —

Commitment and Contingencies (T

Commitment and Contingencies (Tables)	9 Months Ended
	Sep. 30, 2020
Commitments and Contingencies Disclosure [Abstract]
Schedule of operating leases	Maturities of lease liabilities under operating leases that had commenced as of September 30, 2020 are as follows (in thousands): Year ending December 31: 2020 (remaining three months) $ 700 2021 3,882 2022 3,425 2023 3,364 2024 3,072 Thereafter 19,975 Total lease payments 34,418 Less: Imputed interest (7,748) Total lease liability $ 26,670

Segments (Tables)

Segments (Tables)	9 Months Ended
	Sep. 30, 2020
Segment Reporting [Abstract]
Schedule of segment revenue	Segment revenue and Adjusted Gross Profit for the three and nine months ended September 30, 2020 and 2019 were as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Revenue Technology $ 27,964 $ 21,160 $ 78,150 $ 61,393 Professional Services 19,227 18,263 57,416 50,047 Total $ 47,191 $ 39,423 $ 135,566 $ 111,440
Schedule of segment adjusted gross profit	Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Adjusted Gross Profit Technology $ 19,115 $ 14,484 $ 53,577 $ 40,986 Professional Services 4,823 6,677 13,624 17,616 Total reportable segments Adjusted Gross Profit 23,938 21,161 67,201 58,602 Less Adjusted Gross Profit reconciling items: Stock-based compensation (1,099) (370) (3,184) (722) Post-acquisition restructuring costs (1) — — — (108) Less other reconciling items: Sales and marketing (14,629) (14,721) (40,618) (35,579) Research and development (13,390) (13,477) (38,539) (33,209) General and administrative (13,297) (11,013) (31,111) (23,333) Depreciation and amortization (4,981) (2,316) (10,952) (6,844) Debt extinguishment costs — — (8,514) (1,670) Interest and other expense, net (3,854) (659) (7,500) (2,924) Net loss before income taxes $ (27,312) $ (21,395) $ (73,217) $ (45,787) ____________________ (1) Post-acquisition restructuring costs included in the Adjusted Gross Profit reconciliation above relate to severance charges following the acquisition of Medicity.

Description of Business and S_4

Description of Business and Summary of Significant Accounting Policies (Details)	Jul. 29, 2019USD ($)$ / sharesshares	Jul. 10, 2019	Sep. 30, 2020USD ($)	Sep. 30, 2019USD ($)	Sep. 30, 2020USD ($)segmentnumber_of_awards	Sep. 30, 2019USD ($)	Apr. 14, 2020$ / shares	Dec. 31, 2019USD ($)
Subsidiary, Sale of Stock [Line Items]
Offering costs					$ 0	$ 4,407,000
Redeemable convertible preferred stock converted into shares of common stock on a one for one basis (in shares) | shares	23,151,481
Conversion ratio (in shares) | shares	1
Stock spit conversion ratio		0.5
Number of operating segments | segment					2
Number of reportable segments | segment					2
Unbilled accounts receivable			$ 1,900,000		$ 1,900,000			$ 2,900,000
Deferred revenue			36,700,000		36,700,000			32,100,000
Deferred commissions current			400,000		400,000
Deferred commissions non current			$ 1,100,000		$ 1,100,000
Capitalized cost amortization period			4 years		4 years
Capitalized deferred fulfillment			$ 300,000		$ 300,000			$ 900,000
Long lived impairment charges			0	$ 0	0	0
Acquisition related costs			1,400,000		2,700,000
Advertising expense			$ 2,200,000	$ 3,400,000	$ 3,200,000	$ 4,500,000
Number of awards | number_of_awards					2
Service period (in years)					4 years
DOS Subscription
Subsidiary, Sale of Stock [Line Items]
Termination period					1 year
Termination notice period					90 days
Senior Notes Due 2025 | Convertible Notes Payable
Subsidiary, Sale of Stock [Line Items]
Conversion price (in dollars per share) | $ / shares							$ 30.60
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2020-10-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Revenue remaining performance obligations			24 months		24 months
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2020-10-01 | DOS Subscription
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Revenue remaining performance obligations			3 years		3 years
Stock Incentive Plan | Performance Shares
Subsidiary, Sale of Stock [Line Items]
Service period (in years)					4 years
IPO
Subsidiary, Sale of Stock [Line Items]
Common stock issued (in shares) | shares	8,050,000
Share price (in dollars per share) | $ / shares	$ 26
Net proceeds after deducting underwriting discounts and commissions and before deducting estimated offering costs	$ 194,600,000
Offering costs	$ 4,600,000
Over-Allotment option
Subsidiary, Sale of Stock [Line Items]
Common stock issued (in shares) | shares	1,050,000

Description of Business and S_5

Description of Business and Summary of Significant Accounting Policies - Schedule of Allowance for Accounts Receivable (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2020USD ($)
Allowance for Credit Losses on Accounts Receivable
Balance at January 1, 2020	$ 534
Current period provision for expected credit losses	822
Less: Write-offs, net of recoveries	(170)
Balance at September 30, 2020	$ 1,186

Description of Business and S_6

Description of Business and Summary of Significant Accounting Policies - Schedule of Property and Equipment Useful Life (Details)	9 Months Ended
	Sep. 30, 2020
Computer equipment | Minimum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	2 years
Computer equipment | Maximum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	3 years
Furniture and fixtures
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	3 years
Computer software | Minimum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	2 years
Computer software | Maximum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	3 years
Capitalized internal-use software costs | Minimum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	2 years
Capitalized internal-use software costs | Maximum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	3 years

Description of Business and S_7

Description of Business and Summary of Significant Accounting Policies - Schedule of Intangible Assets Useful Life (Details)	9 Months Ended
	Sep. 30, 2020
Developed technologies | Minimum
Finite-Lived Intangible Assets [Line Items]
Estimated useful life	2 years
Developed technologies | Maximum
Finite-Lived Intangible Assets [Line Items]
Estimated useful life	10 years
Customer relationships and contract backlog | Minimum
Finite-Lived Intangible Assets [Line Items]
Estimated useful life	2 years
Customer relationships and contract backlog | Maximum
Finite-Lived Intangible Assets [Line Items]
Estimated useful life	7 years
Computer software licenses | Minimum
Finite-Lived Intangible Assets [Line Items]
Estimated useful life	2 years
Computer software licenses | Maximum
Finite-Lived Intangible Assets [Line Items]
Estimated useful life	5 years
Trademarks
Finite-Lived Intangible Assets [Line Items]
Estimated useful life	5 years

Business Combinations - Narrati

Business Combinations - Narrative (Details) - USD ($) $ in Thousands	Sep. 01, 2020	Jul. 31, 2020	Feb. 21, 2020	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Business Acquisition [Line Items]
Payments to acquire business						$ 102,471	$ 0
Service period (in years)						4 years
Pro forma net loss				$ (27,159)	$ (28,828)	$ (83,233)	$ (69,303)
Restricted shares
Business Acquisition [Line Items]
Vesting period			1 year
Restricted Shares Pursuant To Acquisition Agreement | Vesting monthly over one year
Business Acquisition [Line Items]
Vesting period			1 year
Vesting percent			50.00%
Able Health Inc
Business Acquisition [Line Items]
Consideration			$ 21,500
Payments to acquire business			15,200
Common shares issued in acquisition, at fair value			3,300
Contingent consideration			$ 3,000
Interest acquired			100.00%
Number of restricted shares issued			179,392
Revenue attributable to the acquired business						0
Able Health Inc | Restricted shares
Business Acquisition [Line Items]
RSUs granted (in shares)			60,000
Service period (in years)			1 year
Vesting period			1 year
Able Health Inc | Restricted Shares Pursuant To Acquisition Agreement
Business Acquisition [Line Items]
Vesting period			2 years
Healthfinch, Inc
Business Acquisition [Line Items]
Consideration		$ 50,500
Payments to acquire business		16,900
Common shares issued in acquisition, at fair value		27,800
Contingent consideration		$ 5,800
Interest acquired		100.00%
Revenue attributable to the acquired business						0
Viteware LLC
Business Acquisition [Line Items]
Consideration	$ 119,200
Payments to acquire business	69,600
Common shares issued in acquisition, at fair value	41,300
Contingent consideration	$ 8,300
Interest acquired	100.00%
Number of restricted shares issued	203,997
Revenue attributable to the acquired business						$ 900
Viteware LLC | Restricted shares
Business Acquisition [Line Items]
Vesting period	1 year
Vesting percent	25.00%
Viteware LLC | Restricted shares | Vesting monthly over one year
Business Acquisition [Line Items]
Vesting period	1 year
Vesting percent	75.00%
Customer relationships | Able Health Inc
Business Acquisition [Line Items]
Estimated useful life			6 years
Customer relationships | Viteware LLC
Business Acquisition [Line Items]
Estimated useful life	7 years
Developed technologies | Minimum
Business Acquisition [Line Items]
Estimated useful life						2 years
Developed technologies | Maximum
Business Acquisition [Line Items]
Estimated useful life						10 years
Developed technologies | Able Health Inc
Business Acquisition [Line Items]
Estimated useful life			3 years
Developed technologies | Healthfinch, Inc
Business Acquisition [Line Items]
Estimated useful life		3 years
Developed technologies | Viteware LLC
Business Acquisition [Line Items]
Estimated useful life	4 years
Trademarks
Business Acquisition [Line Items]
Estimated useful life						5 years
Trademarks | Able Health Inc
Business Acquisition [Line Items]
Estimated useful life			2 years
Trademarks | Healthfinch, Inc
Business Acquisition [Line Items]
Estimated useful life		2 years
Trademarks | Viteware LLC | Minimum
Business Acquisition [Line Items]
Estimated useful life	2 years
Trademarks | Viteware LLC | Maximum
Business Acquisition [Line Items]
Estimated useful life	5 years
Customer Relationships And Backlogs | Healthfinch, Inc
Business Acquisition [Line Items]
Estimated useful life		7 years
Contract Backlogs | Viteware LLC
Business Acquisition [Line Items]
Estimated useful life	2 years

Business Combinations - Schedul

Business Combinations - Schedule of Recognized Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Sep. 01, 2020	Jul. 31, 2020	Feb. 21, 2020	Dec. 31, 2019
Less liabilities assumed:
Goodwill	$ 107,822				$ 3,694
Able Health Inc
Assets acquired:
Accounts receivable				$ 633
Prepaid expenses and other assets				57
Total assets acquired				8,890
Less liabilities assumed:
Accounts payable and other current liabilities				91
Deferred revenue				762
Net deferred tax liabilities				1,280
Total liabilities assumed				2,133
Total assets acquired, net				6,757
Goodwill				14,725
Total consideration transferred, net of cash acquired				21,482
Able Health Inc | Developed technologies
Assets acquired:
Intangible assets				7,500
Able Health Inc | Customer relationships
Assets acquired:
Intangible assets				600
Able Health Inc | Trademarks
Assets acquired:
Intangible assets				$ 100
Healthfinch, Inc
Assets acquired:
Accounts receivable			$ 1,408
Prepaid expenses and other assets			347
Total assets acquired			20,055
Less liabilities assumed:
Accounts payable and other current liabilities			408
Deferred revenue			2,100
Total liabilities assumed			2,508
Total assets acquired, net			17,547
Goodwill			32,960
Total consideration transferred, net of cash acquired			50,507
Healthfinch, Inc | Developed technologies
Assets acquired:
Intangible assets			8,100
Healthfinch, Inc | Trademarks
Assets acquired:
Intangible assets			200
Healthfinch, Inc | Customer Relationships And Backlogs
Assets acquired:
Intangible assets			$ 10,000
Viteware LLC
Assets acquired:
Accounts receivable		$ 3,220
Prepaid expenses and other assets		469
Total assets acquired		66,089
Less liabilities assumed:
Accounts payable and other current liabilities		766
Deferred revenue		2,589
Total liabilities assumed		3,355
Total assets acquired, net		62,734
Goodwill		56,443
Total consideration transferred, net of cash acquired		119,177
Viteware LLC | Developed technologies
Assets acquired:
Intangible assets		18,000
Viteware LLC | Customer relationships
Assets acquired:
Intangible assets		43,000
Viteware LLC | Trademarks
Assets acquired:
Intangible assets		$ 1,400

Business Combinations - Pro For

Business Combinations - Pro Forma Information (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Business Combinations [Abstract]
Total pro forma revenues	$ 52,525	$ 44,745	$ 154,363	$ 123,998
Pro forma net loss	(27,159)	(28,828)	(83,233)	(69,303)
Acquisition Related Fair Value Adjustments
Business Acquisition [Line Items]
Net income (loss)	$ 200	$ (7,400)	$ (11,200)	$ (23,500)

Revenue - Schedule of Revenue D

Revenue - Schedule of Revenue Disaggregated by Type of Arrangement (Details) - USD ($) $ in Thousands		3 Months Ended		9 Months Ended
		Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Disaggregation of Revenue [Line Items]
Revenue	[1]	$ 47,191	$ 39,423	$ 135,566	$ 111,440
Recurring technology
Disaggregation of Revenue [Line Items]
Revenue		27,964	21,160	78,150	61,393
Professional services
Disaggregation of Revenue [Line Items]
Revenue	[1]	$ 19,227	$ 18,263	$ 57,416	$ 50,047
[1]	Includes amounts attributable to related party transactions. See Note 16 for further details.

Revenue - Narrative (Details)

Revenue - Narrative (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Geographic Concentration Risk | Revenue from Contract with Customer Benchmark | Outside US
Disaggregation of Revenue [Line Items]
Revenue related to contracts with customers (less than)	0.10%	0.10%	0.10%	0.10%

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Narrative (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2020USD ($)	Sep. 30, 2019USD ($)	Sep. 30, 2020USD ($)segment	Sep. 30, 2019USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
Number of operating segments | segment			2
Number of reporting units | segment			2
Amortization of intangible assets | $	$ 4,300,000	$ 1,600,000	$ 8,800,000	$ 4,700,000
Goodwill impairment loss | $	$ 0	$ 0	$ 0	$ 0

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Schedule of Goodwill by Reporting Unit (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Goodwill [Line Items]
Goodwill	$ 107,822	$ 3,694
Technology
Goodwill [Line Items]
Goodwill	107,040	2,912
Professional Services
Goodwill [Line Items]
Goodwill	$ 782	$ 782

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Schedule of Intangible Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Finite-Lived Intangible Assets [Line Items]
Gross	$ 136,484	$ 47,507
Accumulated Amortization	(30,558)	(21,972)
Net	105,926	25,535
Developed technologies
Finite-Lived Intangible Assets [Line Items]
Gross	69,729	36,129
Accumulated Amortization	(21,911)	(16,548)
Net	47,818	19,581
Customer relationships and contracts
Finite-Lived Intangible Assets [Line Items]
Gross	57,764	4,164
Accumulated Amortization	(4,444)	(2,773)
Net	53,320	1,391
Computer software licenses
Finite-Lived Intangible Assets [Line Items]
Gross	7,291	7,114
Accumulated Amortization	(4,115)	(2,576)
Net	3,176	4,538
Trademarks
Finite-Lived Intangible Assets [Line Items]
Gross	1,700	100
Accumulated Amortization	(88)	(75)
Net	$ 1,612	$ 25

Property and Equipment - Compon

Property and Equipment - Components of Property and Equipment (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 16,629	$ 14,090
Less: accumulated depreciation	(11,310)	(9,795)
Property and equipment, net	5,319	4,295
Computer equipment
Property, Plant and Equipment [Line Items]
Property and equipment	7,794	7,951
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment	4,182	2,234
Furniture and fixtures
Property, Plant and Equipment [Line Items]
Property and equipment	1,041	1,030
Capitalized internal-use software costs
Property, Plant and Equipment [Line Items]
Property and equipment	2,617	1,866
Computer software
Property, Plant and Equipment [Line Items]
Property and equipment	958	972
Equipment
Property, Plant and Equipment [Line Items]
Capital lease equipment	$ 37	$ 37

Property and Equipment - Narrat

Property and Equipment - Narrative (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Property, Plant and Equipment [Abstract]
Depreciation expense	$ 0.7	$ 0.7	$ 2.2	$ 2.2

Short-term Investments (Details

Short-term Investments (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Investments, Debt and Equity Securities [Abstract]
Realized gains (losses)	$ 0	$ 0	$ 0	$ 0
Interest receivable	700,000		700,000		$ 900,000
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	264,758,000		264,758,000		227,346,000
Unrealized Gains	54,000		54,000		79,000
Unrealized Losses	(1,000)		(1,000)		(5,000)
Fair Value	264,811,000		264,811,000		227,420,000
Money market funds
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	100,913,000		100,913,000		17,175,000
Unrealized Gains	0		0		0
Unrealized Losses	0		0		0
Fair Value	100,913,000		100,913,000		17,175,000
U.S. Treasury notes
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	49,571,000		49,571,000		58,130,000
Unrealized Gains	23,000		23,000		34,000
Unrealized Losses	0		0		0
Fair Value	49,594,000		49,594,000		58,164,000
Commercial paper
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	51,883,000		51,883,000		46,973,000
Unrealized Gains	0		0		0
Unrealized Losses	0		0		0
Fair Value	51,883,000		51,883,000		46,973,000
Corporate bonds
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	59,364,000		59,364,000		64,978,000
Unrealized Gains	30,000		30,000		27,000
Unrealized Losses	(1,000)		(1,000)		(5,000)
Fair Value	59,393,000		59,393,000		65,000,000
Asset-backed securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	3,027,000		3,027,000		40,090,000
Unrealized Gains	1,000		1,000		18,000
Unrealized Losses	0		0		0
Fair Value	3,028,000		3,028,000		40,108,000
Cash equivalents
Debt Securities, Available-for-sale [Line Items]
Fair Value	100,913,000		100,913,000		17,175,000
Cash equivalents | Money market funds
Debt Securities, Available-for-sale [Line Items]
Fair Value	100,913,000		100,913,000		17,175,000
Cash equivalents | U.S. Treasury notes
Debt Securities, Available-for-sale [Line Items]
Fair Value	0		0		0
Cash equivalents | Commercial paper
Debt Securities, Available-for-sale [Line Items]
Fair Value	0		0		0
Cash equivalents | Corporate bonds
Debt Securities, Available-for-sale [Line Items]
Fair Value	0		0		0
Cash equivalents | Asset-backed securities
Debt Securities, Available-for-sale [Line Items]
Fair Value	0		0		0
Short-term Investments
Debt Securities, Available-for-sale [Line Items]
Fair Value	163,898,000		163,898,000		210,245,000
Short-term Investments | Money market funds
Debt Securities, Available-for-sale [Line Items]
Fair Value	0		0		0
Short-term Investments | U.S. Treasury notes
Debt Securities, Available-for-sale [Line Items]
Fair Value	49,594,000		49,594,000		58,164,000
Short-term Investments | Commercial paper
Debt Securities, Available-for-sale [Line Items]
Fair Value	51,883,000		51,883,000		46,973,000
Short-term Investments | Corporate bonds
Debt Securities, Available-for-sale [Line Items]
Fair Value	59,393,000		59,393,000		65,000,000
Short-term Investments | Asset-backed securities
Debt Securities, Available-for-sale [Line Items]
Fair Value	$ 3,028,000		$ 3,028,000		$ 40,108,000

Fair Value of Financial Instr_3

Fair Value of Financial Instruments - Narrative (Details) - USD ($)	Feb. 21, 2020	Sep. 30, 2020	Sep. 01, 2020	Dec. 31, 2019
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value		$ 264,811,000		$ 227,420,000
Liabilities measured at fair value on recurring basis				0
Able Health Inc
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Contingent consideration	$ (3,000,000)
Number of shares issuable, contingent consideration (up to)	145,036
Viteware LLC
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Contingent consideration			$ (8,300,000)
Contingent consideration paid in a combination cash	50.00%
Contingent consideration paid in a combination shares (in shares)	50.00%
U.S. Treasury notes
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value		49,594,000		58,164,000
Commercial paper
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value		51,883,000		46,973,000
Corporate bonds
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value		59,393,000		65,000,000
Asset-backed securities
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value		3,028,000		40,108,000
Fair value, recurring
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Money market funds		100,913,000		17,175,000
Total		248,639,000		227,420,000
Fair value, recurring | Level 1
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Money market funds		100,913,000		17,175,000
Total		150,507,000		75,339,000
Fair value, recurring | Level 2
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Money market funds		0		0
Total		114,304,000		152,081,000
Fair value, recurring | Level 3
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Money market funds		0		0
Total		(16,172,000)		0
Fair value, recurring | U.S. Treasury notes
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value		49,594,000		58,164,000
Fair value, recurring | U.S. Treasury notes | Level 1
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value		49,594,000		58,164,000
Fair value, recurring | U.S. Treasury notes | Level 2
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value		0		0
Fair value, recurring | U.S. Treasury notes | Level 3
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value		0		0
Fair value, recurring | Commercial paper
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value		51,883,000		46,973,000
Fair value, recurring | Commercial paper | Level 1
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value		0		0
Fair value, recurring | Commercial paper | Level 2
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value		51,883,000		46,973,000
Fair value, recurring | Commercial paper | Level 3
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value		0		0
Fair value, recurring | Corporate bonds
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value		59,393,000		65,000,000
Fair value, recurring | Corporate bonds | Level 1
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value		0		0
Fair value, recurring | Corporate bonds | Level 2
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value		59,393,000		65,000,000
Fair value, recurring | Corporate bonds | Level 3
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value		0		0
Fair value, recurring | Asset-backed securities
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value		3,028,000		40,108,000
Contingent consideration		(16,172,000)
Fair value, recurring | Asset-backed securities | Level 1
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value		0		0
Contingent consideration		0
Fair value, recurring | Asset-backed securities | Level 2
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value		3,028,000		40,108,000
Contingent consideration		0
Fair value, recurring | Asset-backed securities | Level 3
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value		0		$ 0
Contingent consideration		$ (16,172,000)

Fair Value of Financial Instr_4

Fair Value of Financial Instruments - Schedule of Contingent Consideration (Details) - Contingent Consideration $ in Thousands	9 Months Ended
	Sep. 30, 2020USD ($)
Fair Value Measurements Using Significant Unobservable Inputs (Level 3)
Balance at December 31, 2019	$ 0
Initial contingent consideration liabilities from acquisitions (see Note 2)	17,176
Change in fair value of contingent consideration liabilities	(1,004)
Balance at September 30, 2020	$ 16,172

Accrued liabilities (Details)

Accrued liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Payables and Accruals [Abstract]
Accrued compensation and benefit expenses	$ 7,041	$ 4,278
Interest payable	2,636	0
Other accrued liabilities	4,384	4,666
Total accrued liabilities	$ 14,061	$ 8,944

Convertible Senior Notes and _3

Convertible Senior Notes and Credit Facilities - Narrative (Details)	Sep. 30, 2020USD ($)$ / shares	Apr. 14, 2020USD ($)daysegment$ / sharesshares	Apr. 09, 2020USD ($)	Feb. 06, 2019USD ($)	Sep. 30, 2020USD ($)$ / shares	Sep. 30, 2019USD ($)	Sep. 30, 2020USD ($)$ / shares	Sep. 30, 2019USD ($)	Apr. 08, 2020$ / instrument	Dec. 31, 2019USD ($)
Line of Credit Facility [Line Items]
Debt discount and issue costs										$ 1,800,000
Achievement of minimum trailing							12 months
Loss on extinguishment of debt					$ 0	$ 0	$ 8,514,000	$ 1,670,000
Share price (in dollars per share) | $ / shares	$ 36.60				$ 36.60		$ 36.60
Capped Call | Cash Flow Hedging | Designated as Hedging Instrument
Line of Credit Facility [Line Items]
Derivative, cost of hedge			$ 21,700,000
Derivative, cap price | $ / instrument									42
OrbiMed Royalty Opportunities II, LP | Senior Term Loan
Line of Credit Facility [Line Items]
Total amount available				$ 80,000,000
Interest rate				10.00%
Debt discount and issue costs		$ 1,500,000
Maximum borrowing capacity				$ 50,000,000
Additional borrowing capacity available				30,000,000
Payments of financing costs				2,400,000
Debt issuance costs				300,000
Debt covenant on minimum requirement on technology revenue for 12 months to borrow 1				60,000,000
Debt covenant on minimum requirement on technology revenue for 12 months to borrow 2				$ 80,000,000
Exit fee				5.00%
Debt prepayment term				48 months
Repayments of debt		57,000,000
Loss on extinguishment of debt		8,500,000
Debt instrument, fee amount		7,000,000
Silicon Valley Bank | Loan and Security Agreement
Line of Credit Facility [Line Items]
Maximum borrowing capacity				$ 5,000,000
Cash or cash equivalents on deposits				5,000,000
Option to increase the maximum borrowing capacity				10,000,000
Minimum | OrbiMed Royalty Opportunities II, LP | Senior Term Loan
Line of Credit Facility [Line Items]
Debt covenant borrowing capacity based on technology revenue				$ 25,000,000
Repayment premium (in percentage)				9.00%
Maximum | OrbiMed Royalty Opportunities II, LP | Senior Term Loan
Line of Credit Facility [Line Items]
Debt covenant borrowing capacity based on technology revenue				$ 10,000,000
Debt covenant borrowing capacity based on technology revenue				$ 30,000,000
LIBOR | OrbiMed Royalty Opportunities II, LP | Senior Term Loan
Line of Credit Facility [Line Items]
Contractual interest rate- basis spread on variable rate				7.50%
Senior Notes Due 2025 | Convertible Notes Payable
Line of Credit Facility [Line Items]
Total amount available		$ 230,000,000
Interest rate		2.50%
Proceeds from issuance of debt		$ 222,500,000
Threshold percentage of stock price trigger		130.00%
Threshold trading days | day		20
Threshold consecutive trading days | segment		30
Redemption price percent		100.00%
Number of shares issued in conversion (in shares) | shares		0.0326797
Conversion price (in dollars per share) | $ / shares		$ 30.60
Convertible debt, liability component, fair value disclosure		$ 166,700,000
Convertible debt, equity component, fair value disclosure		63,300,000
Debt issuance cost, liability component		5,500,000
Debt issuance cost, equity component		$ 2,100,000
If-converted value in excess of the principal	$ 45,100,000
Senior Notes Due 2025 | Convertible Notes Payable | Debt Instrument, Convertible, Conversion Price Threshold
Line of Credit Facility [Line Items]
Threshold percentage of stock price trigger		130.00%
Threshold trading days | day		20
Threshold consecutive trading days | day		30
Senior Notes Due 2025 | Convertible Notes Payable | Debt Instrument, Convertible, Sale Price Of Stock Threshold
Line of Credit Facility [Line Items]
Threshold percentage of stock price trigger		98.00%
Threshold trading days | day		5
Threshold consecutive trading days | day		5
Senior Notes Due 2025 | Convertible Notes Payable | Measurement Input, Discount Rate
Line of Credit Facility [Line Items]
Measurement input, debt		0.10

Convertible Senior Notes and _4

Convertible Senior Notes and Credit Facilities - Carrying Value of Liability Component (Details) - Senior Notes Due 2025 - Convertible Notes Payable $ in Thousands	Sep. 30, 2020USD ($)
Debt Instrument [Line Items]
Principal	$ 230,000
Less: Unamortized debt discount	(58,763)
Less: Unamortized issuance costs	(5,037)
Net carrying amount	$ 166,200

Convertible Senior Notes and _5

Convertible Senior Notes and Credit Facilities - Schedule Of Equity Component Of the Notes (Details) - Convertible Notes Payable - Senior Notes Due 2025 $ in Thousands	Sep. 30, 2020USD ($)
Debt Instrument [Line Items]
Proceeds allocated to the conversion option (debt discount)	$ 63,270
Less: Issuance costs	(2,057)
Net carrying amount	$ 61,213

Convertible Senior Notes and _6

Convertible Senior Notes and Credit Facilities - Interest Expense Recognized (Details) - USD ($) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2020	Sep. 30, 2019
Debt Instrument [Line Items]
Amortization of debt discount and issuance costs		$ 5,260	$ 797
Senior Notes Due 2025 | Convertible Notes Payable
Debt Instrument [Line Items]
Contractual interest expense	$ 1,437	2,635
Amortization of debt discount and issuance costs	2,720	4,931
Total	$ 4,157	$ 7,566

Convertible Senior Notes and _7

Convertible Senior Notes and Credit Facilities - Schedule Of Credit Facility (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Line of Credit Facility [Line Items]
Balance		$ 50,000
Remaining Capacity		35,000
Less: Current portion of credit facilities		0
Credit facilities, less current portion		50,000
Term Loan [Member]
Line of Credit Facility [Line Items]
Balance		50,000
Remaining Capacity		$ 30,000
Interest Rate		10.00%
Revolving Credit Facility
Line of Credit Facility [Line Items]
Balance		$ 0
Remaining Capacity		$ 5,000
Interest Rate		5.25%
Revolving Credit Facility | Minimum
Line of Credit Facility [Line Items]
Basis Rate	10.00%	10.00%
Revolving Credit Facility | LIBOR
Line of Credit Facility [Line Items]
Basis Rate	7.50%	7.50%
Revolving Credit Facility | Prime Rate
Line of Credit Facility [Line Items]
Basis Rate	0.50%	0.50%

Stockholders_ Equity (Deficit)

Stockholders’ Equity (Deficit) - Narrative (Details) - $ / shares	Jul. 29, 2019	Sep. 30, 2020	Dec. 31, 2019
Stockholders' Equity Note [Abstract]
Common stock, shares authorized (in shares)	500,000,000	500,000,000	500,000,000
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001	$ 0.001
Preferred stock, shares authorized (up to)	25,000,000	25,000,000	25,000,000
Staggered terms	3 years
Preferred stock, shares outstanding (in shares)		0	0
Preferred stock, shares issued (in shares)		0	0
Number shares issued		42,239,922	36,731,632
Number of shares outstanding		42,239,922	36,731,632
Number of shares issued to former employees with notes determined to be nonrecourse		52,778	52,778
Number of votes per share		1

Net Loss Per Share - Schedule o

Net Loss Per Share - Schedule of the Calculation of Basic and Diluted Net Loss Per Share Attributable to Common Stockholders (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Numerator:
Net loss attributable to common stockholders	$ (27,326)	$ (39,586)	$ (71,999)	$ (226,656)
Denominator:
Weighted-average shares outstanding used in calculating net loss per share attributable to common stockholders, basic and diluted (in shares)	40,292,380	28,222,555	38,517,272	12,749,903
Net loss per share attributable to common stockholders, basic and diluted (in dollars per share)	$ (0.68)	$ (1.40)	$ (1.87)	$ (17.78)

Net Loss Per Share - Schedule_2

Net Loss Per Share - Schedule of Share Totals with a Potentially Dilutive Impact (Details) - shares	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares with a potentially dilutive impact	7,837,166	8,319,185
Common stock options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares with a potentially dilutive impact	4,530,982	7,923,437
Restricted stock units
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares with a potentially dilutive impact	2,107,714	257,278
Shares related to convertible senior notes
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares with a potentially dilutive impact	743,665	0
Restricted shares
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares with a potentially dilutive impact	370,639	0
Employee stock purchase plan
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares with a potentially dilutive impact	84,166	138,470

Net Loss Per Share - Narrative

Net Loss Per Share - Narrative (Details)	Apr. 14, 2020$ / shares
Senior Notes Due 2025 | Convertible Notes Payable
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Conversion price (in dollars per share)	$ 30.60

Stock-Based Compensation - Narr

Stock-Based Compensation - Narrative (Details)	Sep. 01, 2020shares	Feb. 21, 2020shares	Jul. 28, 2019shares	Jul. 31, 2019shares	Sep. 30, 2020USD ($)$ / sharesshares	Sep. 30, 2020USD ($)number_of_awards$ / sharesshares	Sep. 30, 2019USD ($)	Jan. 01, 2020shares	Dec. 31, 2019shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Service period (in years)						4 years
Share based compensation costs capitalized | $					$ 100,000	$ 100,000
Shares granted (in shares)					0	0
Number of shares issued to former employees with notes determined to be nonrecourse					52,778	52,778			52,778
Proceeds from employee stock purchase plan | $						$ 3,528,000	$ 1,216,000
Unrecognized ESPP compensation | $						$ 29,393,000	$ 2,177,000
Number of awards | number_of_awards						2
Able Health Inc
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of restricted shares issued		179,392
Viteware LLC
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares authorized (in shares)					12,750	12,750
Number of restricted shares issued	203,997
Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares exercised in period | $						$ 65,800,000
Total grant-date fair value of stock options vested | $						8,100,000
Nonvested award options, unrecognized compensation expense | $					$ 9,400,000	$ 9,400,000
Nonvested awards, period for recognition						1 year 9 months 18 days
Restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Nonvested awards, period for recognition						3 years 1 month 6 days
Vesting period						4 years
Unrecognized stock-based compensation expense | $					$ 58,900,000	$ 58,900,000
Restricted stock units | Cliff vesting
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period						1 year
Vesting percent						25.00%
Employee stock purchase plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares authorized (in shares)				750,000
Percentage increase of the number of common stock shares (in percentage)				1.00%
Shares available for grant (in shares)					885,437	885,437			367,316
Unrecognized stock-based compensation expense | $					$ 400,000	$ 400,000
ESPP share increase in period (in shares)				750,000
Stock plan offering period						6 months
Maximum employee subscription rate					15.00%	15.00%
Maximum purchase value during offering period | $						$ 25,000,000
Denominator of lowest purchase of a participant (in shares)					2,500	2,500
Purchase price of common stock (in percentage)					85.00%	85.00%
Number of shares issued in ESPP						97,113
Weighted average price per share (in USD per share) | $ / shares					$ 24.79	$ 24.79
Proceeds from employee stock purchase plan | $						$ 2,400,000
Shares issued to employees based on ESPP						84,116
Restricted shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Nonvested awards, period for recognition						9 months 18 days
Vesting period		1 year
Unrecognized stock-based compensation expense | $					$ 8,100,000	$ 8,100,000
Restricted shares | Able Health Inc
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Service period (in years)		1 year
Vesting period		1 year
Restricted shares | Viteware LLC
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period	1 year
Vesting percent	25.00%
Restricted shares | Viteware LLC | Vesting monthly over one year
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period	1 year
Vesting percent	75.00%
Stock Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares authorized (in shares)			2,756,607		13,109,459	13,109,459			11,272,878
Shares available for grant (in shares)					2,597,856	2,597,856			2,309,370
2019 Stock Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares authorized (in shares)			2,500,000					1,836,581
2011 Stock Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of additional shares authorized (in shares)			256,607
Percentage increase of the number of common stock shares (in percentage)			5.00%

Stock-Based Compensation - Effe

Stock-Based Compensation - Effect of Stock-based Compensation Expense on Statement of Operations (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 9,496	$ 9,974	$ 27,283	$ 13,028
Cost of revenue
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	1,099	370	3,184	722
Sales and marketing
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	3,233	1,358	9,724	2,639
Research and development
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	2,025	3,067	5,987	3,502
General and administrative
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	3,139	5,179	8,388	6,165
Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	1,775	8,907	6,251	11,961
Restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	5,374	666	15,784	666
Employee stock purchase plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	450	401	1,418	401
Restricted shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 1,897	$ 0	$ 3,830	$ 0

Stock-Based Compensation - Stoc

Stock-Based Compensation - Stock Option Assumptions (Details)	9 Months Ended
	Sep. 30, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (in years)	6 years 3 months 18 days
Expected dividends	0.00%
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected volatility	43.80%
Risk-free interest rate	2.40%
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected volatility	44.50%
Risk-free interest rate	2.50%

Stock-Based Compensation - St_2

Stock-Based Compensation - Stock Option Activity (Details) - USD ($) $ / shares in Units, $ in Thousands	9 Months Ended
	Sep. 30, 2020
Time-Based Option Shares
Outstanding at January 1, 2020 (in shares)	7,847,716
Options exercised (in shares)	(3,116,393)
Options cancelled/forfeited (in shares)	(200,341)
Outstanding at June 30, 2020 (in shares)	4,530,982
Vested and expected to vest as of September 30, 2020	4,530,982
Vested and exercisable as of September 30, 2020	2,322,807
Weighted Average Exercise Price
Outstanding, beginning balance (in USD per share)	$ 10.67
Options exercised (in USD per share)	9.43
Options cancelled/forfeited (in USD per share)	11.73
Outstanding, ending balance (in USD per share)	11.48
Vested and expected to vest (in USD per share)	11.48
Vested and exercisable (in USD per share)	$ 10.56
Option shares outstanding, Weighted Average Remaining Contractual Life in Years	7 years 2 months 12 days
Vested and expected to vest, Weighted Average Remaining Contractual Life in Years	7 years 2 months 12 days
Vested and exercisable, Weighted Average Remaining Contractual Life in Years	6 years 6 months
Outstanding, Aggregate Intrinsic Value	$ 113,836
Vested and expected to vest, Aggregate Intrinsic Value	113,836
Vested and exercisable, Aggregate Intrinsic Value	$ 60,496

Stock-Based Compensation - Rest

Stock-Based Compensation - Restricted Stock Unit Activity (Details) - Restricted stock units	9 Months Ended
	Sep. 30, 2020$ / sharesshares
Restricted Stock Units
Unvested and outstanding, beginning balance (in shares) | shares	503,861
RSUs granted (in shares) | shares	1,819,229
RSUs vested (in shares) | shares	(144,583)
RSUs forfeited (in shares) | shares	(70,793)
Unvested and outstanding, ending balance (in shares) | shares	2,107,714
Weighted Average Grant Date Fair Value
Unvested and outstanding, beginning balance, grant date fair value (in USD per share) | $ / shares	$ 37.57
RSUs granted (in USD per share) | $ / shares	33.41
RSUs vested (in USD per share) | $ / shares	38.04
RSUs forfeited (in USD per share) | $ / shares	33.83
Unvested and outstanding, ending balance, grant date fair value (in USD per share) | $ / shares	$ 34.07

Stock-Based Compensation - Sche

Stock-Based Compensation - Schedule of the Purchase Right for the ESPP Option Assumptions (Details) - USD ($)	3 Months Ended	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (in months)		6 years 3 months 18 days
Employee stock purchase plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected volatility	79.80%
Expected term (in months)	6 months
Risk-free interest rate	0.17%
Expected dividends	$ 0

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Income Tax Disclosure [Abstract]
Effective income tax rate	(0.10%)	(0.10%)	1.70%	(0.10%)
Income tax (benefit) provision	$ 14	$ 21	$ (1,218)	$ 43
Change in valuation allowance			$ 1,300

Commitments and Contingencies -

Commitments and Contingencies - Narrative (Details) $ in Thousands	1 Months Ended		3 Months Ended		9 Months Ended
	Aug. 31, 2020USD ($)ft²	Jun. 30, 2020USD ($)ft²	Sep. 30, 2020USD ($)	Sep. 30, 2019USD ($)	Sep. 30, 2020USD ($)	Sep. 30, 2019USD ($)	Jul. 01, 2020USD ($)	Dec. 31, 2019
Lessee, Lease, Description [Line Items]
Future lease payments			$ 31,700		$ 31,700
Lease term			11 years		11 years
Net rentable area | ft²	53,297	64,910
Operating lease right-of-use assets obtained in exchange for operating lease obligations	$ 10,800	$ 13,000			$ 24,456	$ 581
Additional future lease payments							$ 2,800
Operating expense			$ 1,300	$ 1,100	$ 2,900	$ 2,700
Weighted-average remaining operating lease term			10 years 4 months 24 days		10 years 4 months 24 days			2 years 2 months 12 days
Weighted-average operating lease discount rate			5.10%		5.10%			5.60%
Minimum
Lessee, Lease, Description [Line Items]
Renewal term			1 year		1 year
Maximum
Lessee, Lease, Description [Line Items]
Renewal term			5 years		5 years

Commitments and Contingencies_2

Commitments and Contingencies - Schedule Of Operating Lease Maturities (Details) $ in Thousands	Sep. 30, 2020USD ($)
Commitments and Contingencies Disclosure [Abstract]
2020 (remaining three months)	$ 700
2021	3,882
2022	3,425
2023	3,364
2024	3,072
Thereafter	19,975
Total lease payments	34,418
Less: Imputed interest	(7,748)
Total lease liability	$ 26,670

Deferred Revenue and Performa_2

Deferred Revenue and Performance Obligations - Narrative (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Product Information [Line Items]
Percentage of revenue recognized was included in deferred revenue (in percentage)	44.00%	48.00%	19.00%	18.00%
Revenue remaining performance obligation amount	$ 85.8		$ 85.8
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2020-10-01
Product Information [Line Items]
Revenue remaining performance obligations	24 months		24 months
Technology and professional services
Product Information [Line Items]
Service contract term (up to)			3 years
Allowed termination period			1 year
Notice required for termination			90 days

Deferred Revenue and Performa_3

Deferred Revenue and Performance Obligations - Remaining Performance Obligation (Details)	Sep. 30, 2020
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2020-10-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Remaining performance obligation (in percentage)	75.00%

Related Parties (Details)

Related Parties (Details) - USD ($) $ in Thousands		3 Months Ended		9 Months Ended
		Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Related Party Transaction [Line Items]
Deferred revenue with related party	[1]	$ 0		$ 0		$ 1,860
Board member
Related Party Transaction [Line Items]
Revenue recognized from related party		700	$ 800	1,800	$ 2,300
Receivables from related party		1,200		1,200		600
Deferred revenue with related party		700		700		500
Acquisition-related consideration payable to related party		$ 1,300		$ 1,300		$ 1,200
[1]	Includes amounts attributable to related party transactions. See Note 16 for further details.

Segments - Narrative (Details)

Segments - Narrative (Details)	9 Months Ended
	Sep. 30, 2020segment
Segment Reporting [Abstract]
Number of operating segments	2
Number of reportable segments	2

Segments - Scheduled of Segment

Segments - Scheduled of Segment Revenue (Details) - USD ($) $ in Thousands		3 Months Ended		9 Months Ended
		Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue	[1]	$ 47,191	$ 39,423	$ 135,566	$ 111,440
Technology
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue		27,964	21,160	78,150	61,393
Professional Services
Segment Reporting, Revenue Reconciling Item [Line Items]
Revenue		$ 19,227	$ 18,263	$ 57,416	$ 50,047
[1]	Includes amounts attributable to related party transactions. See Note 16 for further details.

Segments - Schedule of Segment

Segments - Schedule of Segment Adjusted Gross Profit (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Less Adjusted Gross Profit reconciling items:
Stock-based compensation	$ (9,496)	$ (9,974)	$ (27,283)	$ (13,028)
Less other reconciling items:
Sales and marketing	(14,629)	(14,721)	(40,618)	(35,579)
Research and development	(13,390)	(13,477)	(38,539)	(33,209)
General and administrative	(13,297)	(11,013)	(31,111)	(23,333)
Depreciation and amortization	(4,981)	(2,316)	(10,952)	(6,844)
Debt extinguishment costs	0	0	(8,514)	(1,670)
Interest and other expense, net	(3,854)	(659)	(7,500)	(2,924)
Loss before income taxes	(27,312)	(21,395)	(73,217)	(45,787)
Operating segments
Adjusted Gross Profit
Adjusted Gross Profit	23,938	21,161	67,201	58,602
Operating segments | Technology
Adjusted Gross Profit
Adjusted Gross Profit	19,115	14,484	53,577	40,986
Operating segments | Professional Services
Adjusted Gross Profit
Adjusted Gross Profit	4,823	6,677	13,624	17,616
Segment reconciling items
Less Adjusted Gross Profit reconciling items:
Stock-based compensation	(1,099)	(370)	(3,184)	(722)
Post-acquisition restructuring costs	0	0	0	(108)
Less other reconciling items:
Sales and marketing	(14,629)	(14,721)	(40,618)	(35,579)
Research and development	(13,390)	(13,477)	(38,539)	(33,209)
General and administrative	(13,297)	(11,013)	(31,111)	(23,333)
Depreciation and amortization	(4,981)	(2,316)	(10,952)	(6,844)
Debt extinguishment costs	0	0	(8,514)	(1,670)
Interest and other expense, net	$ (3,854)	$ (659)	$ (7,500)	$ (2,924)