Our programs are designed for our Advanced Practice Providers, Nurses, and Pharmacy Team to reach out to patients that have illnesses or medication needs to assure they have the information needed to maintain their health.

The Population Health Clinical team can:

  • Help prevent unnecessary emergency room visits
  • Promote health and well-being
  • Provide referrals to the Behavioral Health program
  • Help patients sign up for MyChart
  • Review and answer questions about discharge orders from the ED and hospital visits
  • Help locate pharmacies, primary care providers and/or specialists
  • Provide information regarding the cost savings of using urgent care offices and employee health for non-emergent needs
  • Find a transportation resource if there are barriers to transportation
  • Provide medication reconciliation and address medication or prescription issues
  • Find medical resources within the UVA Health to assist patients in their healthcare
Amber Inofuentes, MD

Medical Director, Medicine HOME Program

Anna Creamer, PharmD, BCACP


Ava Thomas, MD

Geriatrician, Virginia at Home Program

Bethany Delk, PharmD, BCPS

Pharmacist, Virginia at Home Program

Caitlin Burchfield, DNP, AGPC-NP

Nurse Practitioner, Virginia at Home Program

Drew Harris, MD

Physician Champion - Medical Director, Wise Clinic

F. Marie Perucci-Bailey, PharmD

Pharmacist, Assistant Manager

George H. Lindbeck, MD

Medical Director, Community Paramedicine

Gregory "Ory" Streeter, MD

Physician Champion - Family Medicine

Jeanette Johnson, BSN, RN

RN Care Coordinator, Virginia at Home Program

Jessica Knight, BSN, RN

RN Care Coordinator, Virginia at Home Program

Johnnie Carrico, DNP, FNP-BC

Nurse Practitioner, UVA Wise Clinic

Justin Mutter, MD

Medical Director, Virginia at Home Program

Karen Duffy, AG-ACNP

Nurse Practitioner, Virginia at Home Program

Kelly Love-Schwarz, MSN, RN, CCCTM

RN Care Coordinator, IHM Program

Kristal "Kristi" Miles, RN

RN, UVA Wise Clinic

Leslie Barbour, BA, RN

RN, IHM Program

Mary Wade, RN, BSN

RN Clinician 3, Medicine HOME Program

Max Alberto Luna, MD

Director, Latino Health Initiative

Michelle Clark, BSN, RN-BC

RN Clinician 3, IHM Program

Miriam Gomez-Sanchez, MD

Hospitalist, Medicine HOME Program

Nahed Elias, PharmD


Natalie Jefferson, DNP, APRN, FNP-BC

Nurse Practitioner, IHM Program

Pamela Tetro, FNP-C, CDCES, PMHNP-BC

Nurse Practitioner, Virginia at Home Program

Patrick Watson, NRP

Pre-Hospital Clinician, Community Paramedicine

Quincy Zhong, MD

Physician Champion - UVA Wise, Outpatient Psychiatry

Rebecca Clemo, MD

Physician Champion - Inpatient Hospitalist

Taylor Tereskerz, AS, EMT-I

Pre-Hospital Clinician, Community Paramedicine

Teresa Radford, BSN, CMSRN

Clinical Program Coordinator, Medicine HOME Program

Thedra E. Nichols, MS, RN, FNP-BC

Nurse Practitioner, IHM Program

Tuula Ranta, RN-BC, BSN, MS, Gerontologist

RN Care Coordinator, Virginia at Home Program