## 5 Discussion
Pilot implementation of PHC in Bangladesh found that having a unique patient ID using their cellphone number was the key to identifying patients and further recording clinical data [16]. Meanwhile, in Indonesia, the National Identification Number (NIK) and the social health insurance number can be used to uniquely identify individuals. However, this unique ID cannot be shared easilyand that barrier hinders the interoperability. Commitment is needed to utilize PHCs where cross-sectoral collaboration should be encouraged [19]. The implementation of PHC and community-based telemedicine is facing several challenges. It is necessary to consider implementation costs, initial funding, and program sustainability in primary health centers and district health offices. Health facilities, health care workers, and community health workers should adapt with the new health care model and the training process, anticipating the benefits and perspective of the workload of utilizing telemedicine [40]. Some health care providers are also concerned about medical errors, low patient satisfaction, communication obstruction between doctors and patients, and lack of monitoring of patients' health status [9]. As presented in the PHC study in Bangladesh, another non-technical challenge showed that the doctors found it difficult and uncomfortable to use computers to enter data during consultations which impacts the completeness of the patient's data. This gap will also affect the follow-up process of a patient's care in the future [19]. Organizing community-based health programs requires strong collaboration between the primary health centers and the community. It is necessary to formally delegate the tasks and responsibilities of health care workers and community health workers, while providing better scheduling of community health program activities, and the continuous monitoring and evaluation of the implementation of the PHC. Furthermore, the adoption of new health information systems needs continuous learning and training [41]. The implementation of a PHC should involve various health care providers in the primary health centers such as pharmacists, nutritionists, psychologists, and other stakeholders such as village heads, community leaders, community health workers, and the local residents. Cultural adaptation requires managerial efforts to provide comprehensive planning so that the role of the health office is needed to ensure the sustainability and scaling-up of the PHC to other community health programs such as school health programs, environmental health, and reproductive health [35]. Based on the legal aspects, by definition, the community health workers have roles including health promotion and disease prevention, while mobilizing and encouraging community members to utilize health services and facilitating access to health care [42]. Several community health workers, especially in the LMICs, have additional roles in providing treatment for basic clinical conditions (first aid) and screening [43]. Community health workers also play a role in assisting in the collection and reporting of health status data in the community [42]. A PHC adapts the role of community health workers and provides basic literacy skills through training. For the financial sustainability of the PHC, the burden can be divided between the primary health care funds and village funds provided by the government. The Indonesian government regulation states that the priority for developing village funds is for basic social services such as the provision of infrastructure for public health, including village health posts [44]. Financial and logistic support in providing consultation and treatment for community members who are in the chronic disease management program approved by Health and Social Security Agency can be claimed by the primary health centers.