We designed a medical information management (MIM) system to 1) identify high-risk patients (with cardiopulmonary dysfunction or undergoing major surgery), and 2) augment traditional mechanisms for referring high-risk patients to respiratory specialists. We define MIM as the combination of techniques that solicit, record, transfer, analyze, and distribute patient data according to designated protocols. A randomized trial compared 247 control subjects with 272 surgical patients assisted by information management. Data analysis focused on patients with cardiopulmonary impairment. The results showed that the MIM assisted patients received (1) more preoperative respiratory assessments (83.2 per cent vs. 9.2 per cent) than controls, 2) more preoperative respiratory therapy (37.9 per cent vs. 8.0 per cent) and 3) fewer postoperative respiratory complications (8.4 per cent vs. 16.1 per cent) than controls. These findings suggest that a MIM system can be an effective auxiliary mechanism for improving presurgical care.