## 1 Introduction  
Non-communicable diseases (NCDs) such as cardiovascular diseases, cancers, diabetes, and chronic respiratory diseases are the leading causes of death and disability globally, contributing to 70% of deaths, of which nearly 80% occur in low- and middle-income countries (LMICs) [1]. Epidemiological transition has resulted in the increasing prevalence of NCDs in Indonesia over the last 30 years. This requires the early prevention and control of NCD risk factors during all stages of the life cycle (continuum of care) through cross-program and cross-sector integration. Community health service for NCDs is a priority of primary health centers, which are oriented to control NCDs through the implementation of early detection of the risk factors, counseling, early follow-up, and referrals when needed [2]. The coronavirus disease 2019 (COVID-19) pandemic has had a serious impact on various health programs including NCDs [3]. There has been a change in health-seeking behavior in Indonesia, as indicated by a 14% decrease in primary health center visits [4]. Furthermore, the community health services did not operate regularly and even stopped during the pandemic [5, 6]. The health situation in the community is under-monitored,especially among vulnerable populations, and some people tend to be passive and prefer to be visited by health workers [7]. To overcome these challenges, quality and easily accessible health services need to be developed to ensure resilience to health crises. Additionally, an adaptive and innovative approach is needed through the use of digital technology that enables remote services and the development of a health technology ecosystem [8]. Remote services using mobile technology have the potential to improve health access at the community level. Telemedicine was significantly adopted during the COVID-19 pandemic due to social restrictions and a health facilitation strategy with the aim of providing continuous patient care and promoting more efficient health care services without a reduction in quality [9; 10]. Telemedicine is mostly conducted between health professionals or providers and patients for individual patient care. It provides benefits for patients in terms of cost savings and travel time and reaches communities in which it is difficult to access health facilities, in addition to reducing the contact between health workers and patients during the pandemic [11; 12]. This is important because people with NCDs have a higher risk of complications requiring intensive care and have a worse prognosis if infected with COVID-19 [13; 14]. The development of a health technology ecosystem was planned in the Ministry of Health and Digital Transformation, which created an integrated health data and health service application system for primary and referral health care [2]. TEMENIN has been implemented by the Ministry of Health as a telemedicine services application in health facilities since 2017. The pandemic situation has supported the widespread acceptance of online teleconsultation between health providers and patients [15]. A portable health clinic (PHC) was designed as a community-based telemedicine service and has potential to be linked between community health workers and primary health centers. PHCs are equipped with telemonitoring and teleconsultation using portable medical devices and an Android application. These PHCs were initiated by Kyushu University, Japan, together with Grameen Communication, Bangladesh [16], and have been implemented in several countries, including Bangladesh, Japan, Cambodia, China, India, Malaysia, Pakistan and Thailand [17]. The aim of a PHC is to improve the quality of health services for targeted unreached community members in various health programs including maternal and child health [18], telepathology, tele-eycare and virtual blood banks, as well as for health services during the COVID-19 pandemic [19].