Dr Mark Dancy, England's clinical chairman of the NHS Heart Improvement programme, said tight budgets would not allow GP commissioners to invest in telecare unless extra savings were found elsewhere.
The warning casts doubt on DoH plans to push for a wider roll-out of the technologies, which it believes can improve care for people with long-term conditions while saving money.
Speaking at a telecare event hosted by the Royal College of Physicians in London last week, Dr Dancy said: 'It is unlikely that projects which require investment to save will go ahead initially unless savings are found elsewhere.'
He added that only projects essential to the delivery of the NHS reforms or the Quality, Innovation, Productivity and Prevention (QIPP) agenda were likely to be funded.
With the NHS facing £20bn of efficiency savings, this would mean telecare takes a back seat, as it often requires extensive investment to set up in a region, he said.
David Barrett, a telehealth lecturer from the University of Hull, said the NHS required better evidence that telecare was effective before any mass roll-out. 'What is needed is high quality evidence showing high cost saving,' he said.
The DoH has previously stated its intention to introduce telecare on a wider scale (GP, 26 November 2010). The department says telecare can produce better clinical outcomes and cut unplanned hospital admissions.
But clear evidence for the clinical and cost effectiveness of telecare is lacking.
In May 2008, the DoH commissioned a two-year national pilot called the Whole System Demonstrators project, said to be the largest RCT of telecare in the world.
More than 5,800 patients from GP practices in Cornwall, Kent and the London borough of Newham were enrolled in the scheme, which assessed the effect of telecare on health and social care costs and outcomes.
Findings from the project are due imminently after a delay of several months. It is believed the results, if positive, would then be used to make the case for a wider roll-out of the technology.