ADHD MD Workflow: safety, handoffs, and fewer last‑minute refills
Screen for red flags up front; only offer MD slots when pre‑visit items are complete.
Standardize during‑visit documentation and EPCS readiness.
After the visit, trigger a clear refill workflow and next‑MD date, aligned with state rules.
Red flags — screen first
Unstable bipolar disorder or psychosis
Recent stimulant misuse or stimulant use disorder
Cardiac history or age >55–65 without a recent ECG
Severe eating disorder
Concurrent benzodiazepines or opioids without a clear rationale
Before the MD visit (clinic checklist)
Intake complete in EHR (ADHD screeners, baseline forms)
Prior records uploaded (evals, testing, med history)
Baseline vitals documented or requested (BP/HR, weight)
ADHD diagnosis confirmed with screeners + quantitative test
PDMP report(s) obtained and uploaded
Urine drug screen (UDS) completed and results available
Controlled Substances Agreement signed
Send packet to Dr. Walker via Doximity or EHR task
“Offer MD slots only after the above is confirmed.”
During the MD visit
Confirm diagnosis, risks/benefits, and monitoring plan; document decision and parameters
If EHR has a pre‑populated Rx, Dr. Walker will review and send when appropriate
EPCS readiness: ensure credentials active; identify a backup pharmacy if eRx fails
After the MD visit — clinic actions
Document attendance (show/no‑show)
Record MD decision and prescription status
Record MD visit date and due date for next MD visit
Apply state cadence: typically every 1–2 years; some states require more frequent physician exams
Refill protocol — post‑MD visit
Create EHR refill task and pre‑populate: med, dose, frequency, quantity, refills, pharmacy
Send Doximity message with PHI referencing the EHR task, or generic text (no PHI) to check EHR
Verify PDMP and monitoring are up to date per policy
Turnaround: 24–48 business hours; weekend/holiday → next business day
Efficiency tips
Use pre‑populated refills to speed review and reduce errors
Keep a controlled‑substance agreement aligned with this workflow and state policy
Georgia example (if applicable)
Quarterly physician exam required when an APRN prescribes stimulants; document vitals, PDMP, risk–benefit review, and plan for next exam