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At present, electronic medical records still face difficulties in sharing data on multiple clients and the inability to protect patient privacy. Therefore, the prevention and control of medical information leakage and sharing issues are urgent; In order to solve this problem, the PBFT algorithm was analyzed and the afBFT consensus algorithm was proposed, and its effectiveness was verified; The experimental results show that the average traffic of the Pluggable Consensus based on PBFT (CPBFT) algorithm and the Practical Byzantine Fault Tolerance (PBFT) algorithm during continuous operation is very similar, while the average traffic of the afBFT consensus algorithm is 3.47 kilobytes, which is about 14.1% higher than the PBFT algorithm, but within an acceptable range; The average value of simultaneous block out time can be stable at around 2.4 s; After being attacked, the afBFT consensus algorithm showed strong resistance to predictive attacks, and its application in practical solutions resulted in lower data encryption and search times, within 350ms and 140ms, respectively; Overall, the proposed afBFT consensus algorithm is effective in electronic medical record management applications, and it is of great significance in ensuring the security of multi client medical information sharing.