Epic Navigator (LVN) Guide

In this guide, we’ll review the Navigator (LVN) record INI. Navigators can consist of documentation tools (such as note-based LVN records), review tools (such as review flowsheets or print groups/reports), links (to activities), to name a few. Navigator records can be categorized into the following types of records: Templates, Topics, and Sections. Encounter-based navigators are generally determined by workflow engine rules, however they are occasionally set directly in Activity (E2N) records.

Navigators can be used for face-to-face encounters, such as Hospital Encounters, Office Visits, Procedure Visits, and Clinical Support Visits, as well as non-face-to-face encounters, such as Telephone, Documentation, and Orders Only. Additionally, navigators can also be used in non-clinical settings, such as CRM.

Navigator Templates:

Template-type LVN records are the structure on which the rest of the LVN records are built. Without a template, you cannot display a navigator. Traditionally, navigator templates were designed to contain one or more topics, each of which contained several sections. These navigator templates were defined in the workflow engine rule, which loaded “Visit Navigator” activity after evaluating a set of rules and criteria. A typical structure of a Visit Navigator looked something like this:

In recent versions of Epic, however, we’ve started to see different types of navigator template records, including dual pane, widescreen-view and single-section templates as activities.

Navigator Topics:

Topic-type LVN records are the next level of navigator records below templates. Several topics can be grouped into a single template, and topics were traditionally structured around the types of sections that were within the topics. For example, a typical visit navigator template for an Office Visit encounter type had a Rooming Topic, Orders Topic, and a Charging Topic. The Rooming Topic contained navigator sections such as Vitals, Chief Complaint, and History; The Orders Topic contained sections such as Visit Problem List, and Meds & Orders, and the Charging Topic contained sections such as Charge Capture, LOS, and Patient Instructions. Because there were several Topics contained within a single Template, the caption of the Topic was used as a visual indicator of the separation between Topics. As Epic has evolved over the years, we’ve started to see the Topic itself become less and less important, other than the fact that sections must go in Topics, and cannot be added directly to the Templates themselves. More often than not (with the exception of dual-pane navigator templates), a single Topic is included in each Template, and that Topic does not have a caption.

Navigator Sections:

Finally, we review the navigator sections themselves, which is where the actual functionality of the navigators is contained. There are dozens of different types of navigator sections, and we’ll review a few of them here.

Notes Sections:

These are sections that are used to create Note (HNO) records. These are most often used in Outpatient encounters, as Inpatient encounters typically use the Notes activity (E2N). This allows the users to choose their own Note Type (more on Note Types, here), while in the notes-based sections, the Note Type is defined directly in the LVN (navigator section ) record itself, using the “NoteType=” parameter. The value of the parameter is based on the category value from UCN-31033, for example a section that contained the string, “NoteType=1” in the run parameters item would file a note written in that section as a “Progress Note.” There are lots of other parameters that can be used in Notes sections, such as the ability to force a note into NoteWriter, set the default behavior of the section when it is selected in a visit navigator, or the default behavior of the section when it is closed (Sign vs. Pend the note).

Flowsheet Sections:

These are sections that are used to host Doc Flowsheet Template (FLT) records. Some common examples of flowsheet-based navigator sections are. In general, we’d recommend creating a Flowsheet-based SmartForm, and hosting that in the navigator section, rather than displaying the navigator template directly in the section itself. This allows you to harness the flexibility that SmartForm scripting offers, which will allow you to better show/hide/cascade flowsheet rows, and display section headers/captions/tooltips in the documentation tool. You’re somewhat restricted by what you can do with a flowsheet alone, but when combined with a SmartForm, the possibilities are almost limitless.

SmartForm Sections:

These are sections that allow you to host a SmartForm in the section. The SmartForm could contain Patient-level data, Episode-level data, Encounter-level data, or even Flowsheet-based data. SmartForm-based sections allow for a considerable amount of flexibility and customization, enabling you to create custom data-collection tools for your Epic EMR.

Charging Sections:

These are sections such as Level of Service and Charge Capture, which allow you to manually (or with guidance) drop procedure charge records (EAP) associated with the encounter. Because these sections generate charges that will ultimately generate a bill, you should ensure that these sections are only used in Templates displayed in encounters that contain some sort of Patient Registration.

Report-Based Sections:

These sections allow you to display data directly in the navigator. This could be useful for clinicians who want to review a piece of relevant data alongside some piece of documentation that they are entering themselves.

Activity-Link Sections:

These sections allow you to link directly to Activity (E2N) records. This could be useful in the case where your activity tabs menu is becoming lengthy, forcing the users to have to scroll or access More to see it. Linking directly to an activity from a navigator section can allow for an easier and quicker way to access an Activity from where the end users are already spending most of their time.

A Quick Note on Navigator Configuration (VCN) Records

VCN records control the behavior and display of sections themselves. Some navigator section types are dependent on VCN records to function correctly. To learn more about VCN records, check out our VCN guide here.