Bio


Dr. Roy is a medical oncologist and a clinical assistant professor in the Stanford University School of Medicine Department of Medicine, Division of Medical Oncology. She has expertise in Lung and Thoracic cancers, but with a broad clinical interest in hematology and oncology.

Dr. Roy became an oncologist because of her passion for patient care. She is committed to being a clinician and is focused on improving the patient experience -- from the moment a patient checks in, to how information about their care is conveyed, and how the complex process of getting cancer care can be made a bit more seamless.

Her research interests include access to clinical trials, quality improvement and improving care delivery. In that effort, she has published on work regarding patient reported outcomes (PROs) and their use to help clinical quality efforts- including in the context of a clinical trial with an electronic PRO portal, through distress screening with the Stanford Medicine Cancer Center, and in improving access to such screening and care for patient with limited English proficiency. She is the recipient of both a clinical innovation award through Stanford and an American Society of Clinical Oncology (ASCO) Merit award. She also will serve in the quality leadership from 2022 as Associate Medical Director for Quality at Stanford Cancer Center.

Dr. Roy received her medical degree from Albert Einstein College of Medicine, and then completed residency training at Beth Israel Deaconess Medical Center. She then completed fellowship training in Hematology and Oncology at Stanford. She was chief fellow for her graduating year during fellowship as well.

Clinical Focus


  • Thoracic Oncology
  • Hematology/Oncology

Academic Appointments


Honors & Awards


  • Quality Meeting Conquer Cancer Merit Award, American Society of Clinical Oncology (ASCO) (2021)
  • Induction and Member, Alpha Omega Alpha (2014)
  • Annual Meeting Merit Award, American Society of Clinical Oncology (ASCO) (2020)
  • Humanism in Hematology and Oncology Award, Stanford Departments of Hematology and Oncology (2021)

Boards, Advisory Committees, Professional Organizations


  • Member, American Society of Clinical Oncology (2017 - Present)
  • Member, Association of Northern California Oncologists (2018 - Present)

Professional Education


  • Board Certification: American Board of Internal Medicine, Hematology/Oncology (2021)
  • Board Certification, American Board of Internal Medicine, Hematology (2021)
  • Board Certification, American Board of Internal Medicine, Medical Oncology (2021)
  • Fellowship: Stanford University Hematology and Oncology Fellowship (2021) CA
  • Board Certification: American Board of Internal Medicine, Internal Medicine (2018)
  • Residency: Beth Israel Deaconess Medical Center Internal Medicine Residency (2018) MA
  • Medical Education: Albert Einstein College of Medicine (2015) NY

Community and International Work


  • Volunteer with GO.org

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

Projects


  • Addressing Cancer Distress Screening for patient with Low or Limited English Proficiency, Stanford Cancer Institute

    Location

    Stanford, CA

    Collaborators

  • Analyzing PROMIS Questionnaires and Quality of Life in Cancer Patients

    Location

    Stanford, CA

All Publications


  • Association of treatment type with patient-reported quality of life in cancer distress screening Roy, M., Rosenthal, S., Shah, M. P., Khaki, A., Bozkurt, S., Seto, T., Blayney, D. W., Hernandez-Boussard, T., Ramchandran, K. LIPPINCOTT WILLIAMS & WILKINS. 2021
  • Patients' perception of meaning of life and needed support before and after cancer treatment initiation Roy, M., Rosenthal, S., Shah, M., Khaki, A., Hernandez-Boussard, T., Ramchandran, K. SPRINGER. 2021: S156-S157
  • Association of telemedicine use with disparities in cancer distress screening for patients with limited English proficiency Roy, M., Fardeen, T., Cabot, A., Bruzzone, B., Savadamuthu, V., Kasprick, D., Cheung, L., Teske, E., Ramchandran, K. LIPPINCOTT WILLIAMS & WILKINS. 2021
  • Implementation of a cloud-based electronic patient-reported outcome (ePRO) platform in patients with advanced cancer. Journal of patient-reported outcomes Generalova, O., Roy, M., Hall, E., Shah, S. A., Cunanan, K., Fardeen, T., Velazquez, B., Chu, G., Bruzzone, B., Cabot, A., Fisher, G. A., Srinivas, S., Fan, A. C., Haraldsdottir, S., Wakelee, H. A., Neal, J. W., Padda, S. K., Johnson, T., Heestand, G. M., Hsieh, R. W., Ramchandran, K. 2021; 5 (1): 91

    Abstract

    BACKGROUND: Patient reported outcomes (PROs) have been associated with improved symptom management and quality of life in patients with cancer. However, the implementation of PROs in an academic clinical practice has not been thoroughly described. Here we report on the execution, feasibility and healthcare utilization outcomes of an electronic PRO (ePRO) application for cancer patients at an academic medical center.METHODS: We conducted a randomized trial comparing an experimental ePRO arm to standard of care in patients with advanced cancer in the thoracic, gastrointestinal, and genitourinary oncology groups at Stanford Cancer Center from March 2018 to November 2019. We describe the pre-implementation, implementation, and post-implementation phases of the ePRO arm, technological barriers, electronic health record (EHR) integration, clinician burden, and patient data privacy and security. Feasibility was pre-specified to be at least 70% completion of all questionnaires. Acceptability was based on patient and clinician feedback. Ambulatory healthcare utilization was assessed by reviewing numbers of phone messages, electronic portal messages, and referrals for supportive care.RESULTS: Of 617 ePRO questionnaires sent to 72 patients, 445 (72%) were completed. Most clinicians (87.5%) and patients (93%) felt neutral or positive about the ePRO tool's ease of use. Exposure to ePRO did not cause a measurable change in ambulatory healthcare utilization, with a median of less than two phone messages and supportive care referrals, and 5-6 portal messages.CONCLUSIONS: Web-based ePRO tools for patients with advanced cancer are feasible and acceptable without increasing clinical burden. Key lessons include the importance of pilot testing, engagement of stakeholders at all levels, and the need for customization by disease group. Future directions for this work include completion of EHR integration, expansion to other centers, and development of integrated workflows for routine clinical practice.

    View details for DOI 10.1186/s41687-021-00358-2

    View details for PubMedID 34524558

  • Implementing Patient-Directed Cancer Education Materials Across Nigeria. JCO global oncology Dickerson, J. C., Ibeka, P., Inoyo, I., Oke, O. O., Adewuyi, S. A., Barry, D., Bello, A., Fasawe, O., Garrity, P., Habeebu, M., Huang, F. W., Mulema, V., Nwankwo, K. C., Remen, D., Wiwa, O., Bhatt, A. S., Roy, M. 2021; 7: 1610-1619

    Abstract

    PURPOSE: As access to cancer care expands in low-income countries, developing tools to educate patients is paramount. We took a picture booklet, which was initially developed by the nonprofit Global Oncology for Malawi and Rwanda, and adapted it for use in Nigeria. The primary goal was to assess acceptability and provide education. The secondary goals were (1) to describe the collaboration, (2) to assess knowledge gained from the intervention, (3) to assess patient understanding of their therapy intent, and (4) to explore patient's experiences via qualitative analysis.METHODS: We piloted the original English booklet at a single site and requested feedback from patients and providers. The booklet was updated; translated into Hausa, Yoruba, Igbo, and Pidgin English; and used at three additional sites. For the three-site cohort, we collected basic demographics, pretest and post-test assessing content in the booklet, and performed a qualitative analysis.RESULTS: The original booklet was widely acceptable and recommended by patients at site one (n = 31) and by providers (N = 26) representing all four sites. In the three-site cohort (n = 103), 94% of patients recommended the booklet. An immediate post-test focusing on when patients should present to care showed a statistically significant improvement in one of the seven questions. Fifty-one percent of the patients (n = 103) knew their treatment intent (curative v palliative). Qualitative analysis highlighted that the patient's thoughts on cancer are dominated by negative associations, although curability and modern therapy are also frequently cited.CONCLUSION: We adapted an educational booklet to a novel context and had it delivered by local partners. The booklet was widely recommended to future patients. The booklet had an impact on patient's knowledge of cancer treatment, potentially allowing for decreased abandonment.

    View details for DOI 10.1200/GO.21.00233

    View details for PubMedID 34860566

  • Limited English Proficiency and Disparities in Health Care Engagement Among Patients With Breast Cancer. JCO oncology practice Roy, M. n., Purington, N. n., Liu, M. n., Blayney, D. W., Kurian, A. W., Schapira, L. n. 2021: OP2001093

    Abstract

    Race and ethnicity have been shown to affect quality of cancer care, and patients with low English proficiency (LEP) have increased risk for serious adverse events. We sought to assess the impact of primary language on health care engagement as indicated by clinical trial screening and engagement, use of genetic counseling, and communication via an electronic patient portal.Clinical and demographic data on patients with breast cancer diagnosed and treated from 2013 to 2018 within the Stanford University Health Care system were compiled via linkage of electronic health records, an internal clinical trial database, and the California Cancer Registry. Logistic and linear regression models were used to evaluate for association of clinical trial engagement and patient portal message rates with primary language group.Patients with LEP had significantly lower rates of clinical trial engagement compared with their English-speaking counterparts (adjusted odds ratio [OR], 0.29; 95% CI, 0.16 to 0.51). Use of genetic counseling was similar between language groups. Rates of patient portal messaging did not differ between English-speaking and LEP groups on multivariable analysis; however, patients with LEP were less likely to have a portal account (adjusted OR, 0.89; 95% CI, 0.83 to 0.96). Among LEP subgroups, Spanish speakers were significantly less likely to engage with the patient portal compared with English speakers (estimated difference in monthly rate: OR, 0.43; 95% CI, 0.24 to 0.77).We found that patients with LEP had lower rates of clinical trial engagement and odds of electronic patient portal enrollment. Interventions designed to overcome language and cultural barriers are essential to optimize the experience of patients with LEP.

    View details for DOI 10.1200/OP.20.01093

    View details for PubMedID 33844591

  • Distress Screening Through Patient-Reported Outcomes Measurement Information System (PROMIS) at an Academic Cancer Center and Network Site: Implementation of a Hybrid Model. JCO oncology practice Neal, J. W., Roy, M. n., Bugos, K. n., Sharp, C. n., Galatin, P. S., Falconer, P. n., Rosenthal, E. L., Blayney, D. W., Modaressi, S. n., Robinson, A. n., Ramchandran, K. n. 2021: OP2000473

    Abstract

    Cancer care guidelines recommend regular distress screening of patients, with approximately one in three patients with cancer experiencing significant distress. However, the implementation of such programs is variable and inconsistent. We sought to assess the feasibility of implementing a hybrid electronic and paper screening tool for distress in all patients coming to a large academic cancer center and an associated integrated network site.Patients at an academic cancer center (Stanford Cancer Center) and its associated integrated network site received either an electronic or on-paper modified Patient-Reported Outcomes Measurement Information System-Global Health questionnaire, to assess overall health and distress. We used the Reach, Effectiveness, Adoption, Implementation, and Maintenance implementation framework to test and report on the feasibility of using this questionnaire. Iterative workflow changes were made to implement the questionnaire throughout the healthcare system, including processes to integrate with existing electronic health records.From June 2015 to December 2017, 53,954 questionnaires representing 26,242 patients were collected. Approximately 30% of the questionnaires were completed before the visit on an electronic patient portal. The number of patients meeting the positive screen threshold remained around 40% throughout the study period. Following assessment, there were 3,763 referrals to cancer supportive services. Of note, those with a positive screen were more likely to have a referral to supportive care (odds ratio, 6.4; 95% CI, 5.8 to 6.9; P < .0001).The hybrid electronic and on-paper use of a commonly available patient-reported outcome tool, Patient-Reported Outcomes Measurement Information System-Global Health, as a large-scale distress screening method, is feasible at a large integrated cancer center.

    View details for DOI 10.1200/OP.20.00473

    View details for PubMedID 33830852

  • From metrics to practice: identifying preventable emergency department visits for patients with cancer. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer Roy, M., Halbert, B., Devlin, S., Chiu, D., Graue, R., Zerillo, J. A. 2020

    Abstract

    BACKGROUND: Oncology patients disproportionately utilize the emergency department (ED) for symptom management. At our institution, approximately 1 in 4 visits to the ED by oncology patients led to discharge. We hypothesized that many of the visits leading to ED discharge would be potentially preventable (PP).METHODS: We retrospectively characterized ED discharges of oncology patients. Visits were classified by presenting symptom, type of cancer, and time of ED visit. Chart reviewers were additionally asked whether each case could have been safely managed as an outpatient.RESULTS: We analyzed 100 ED discharges in a 4-month period in 2016 and 2017. Gastrointestinal (GI) complaints, pain, and fever were the most common presenting symptoms for these visits. We rated 44 of 100 ED discharges as potentially preventable. Given we analyzed only ED discharges which comprise about 25% of ED visits for patients with cancer, overall about 10% of all ED visits by these patients may be preventable. We also found that ED visits without a clinic appointment or phone call to the clinic on the day of ED presentation were more likely to be preventable (51% vs 27%, OR 2.9, p = 0.026).CONCLUSIONS: Many ED visits by oncology patients may be preventable and occur for symptoms which can be managed as an outpatient. More of these visits also appear to occur in those who do not reach a clinic member prior to the visit. These findings suggest that improved access to clinics and standardized outpatient symptom management are next steps to consider in preventing ED visits in this vulnerable population.

    View details for DOI 10.1007/s00520-020-05874-3

    View details for PubMedID 33159604

  • Cancer clinical trial consent forms: A readability analysis. Roy, M., Schapira, L. LIPPINCOTT WILLIAMS & WILKINS. 2020
  • Distress screening through PROMIS at an academic cancer center and network site: Implementation of a hybrid model. Roy, M., Neal, J. W., Bugos, K., Sharp, C., Falconer, P., Rosenthal, E., Blayney, D. W., Modaressi, S., Robinson, A., Ramchandran, K. AMER SOC CLINICAL ONCOLOGY. 2020
  • Symptom relief and palliative care in gynecologic oncology. Current opinion in obstetrics & gynecology Roy, M., Ramchandran, K. 2019

    Abstract

    PURPOSE OF REVIEW: Patients with gynecologic malignancies experience varied and often difficult-to-manage symptoms through their disease course, along with decisions surrounding preferences for advance care planning. This review focuses on evidence-based symptom management for these patients and offers a framework for conversations regarding goals of therapy.RECENT FINDINGS: There is increasing literature on palliative care specifically in gynecologic oncology, including barriers and possible solutions for early palliative care use, along with updated guidelines on postoperative pain management and tools for communication.SUMMARY: Integration of early palliative care and focus on symptom management is an important and multidisciplinary approach to help patients with gynecologic malignancies.

    View details for DOI 10.1097/GCO.0000000000000601

    View details for PubMedID 31851044

  • Feasibility and design of a cloud-based digital platform in patients with advanced cancer. Roy, M., Hall, E., Velazquez, B., Shah, S., Fardeen, T., Cunanan, K., San Pedro-Salcedo, M., Wakelee, H. A., Neal, J. W., Padda, S., Das, M., Fan, A. C., Srinivas, S., Fisher, G. A., Haraldsdottir, S., Johnson, T., Chu, G., McMillan, A., Ramchandran, K. AMER SOC CLINICAL ONCOLOGY. 2019