1 Department of Mathematics and Computer Science, Virginia State University, P.O. Box 9068, Petersburg, VA 23806, USA 2 Center for the Study of International Medical Policies and Practices, School of Public Policy, George Mason University, Fairfax, VA 22030, USA 3 AAL International Association, Bischoffsheimlaan 25, 1000 Brussels, Belgium 4 Center for Human Simulation and Patient Safety, School of Medicine, Virginia Commonwealth University, P.O. Box 980480, Richmond, VA 23298, USA 5 Center for Telehealth, Medical College of Georgia, Augusta, GA 30912, USA 6 Health Innovation and Information Technology Centre, Faculty of Medicine, University of Calgary, Calgary, AB, Canada T2N 1N4 7 College of Communication Arts and Sciences, Michigan State University, MI 48824, USA 8 Department of Computer Science, University of Alabama, P.O. Box 870290, Tuscaloosa, AL 35487-0290, USA