The invention discloses an electronic medical record realization method and device based on a blockchain. The method comprises the following steps that: a doctor uses terminal equipment to log in an electronic medical record system; after the doctor finishes checking a patient, the sensitive data of the patient is encrypted through a standard domestic password algorithm, then, the sensitive data of the patient is written into the blockchain, and the unique code of the sensitive data of the corresponding patient is generated and written into the blockchain and a database; the common data of the patient is stored in the database, meanwhile, the common data of the patient is generated into a data fingerprint through an SHA256 standard algorithm, and the data fingerprint is recorded in the blockchain; and the patient logs in the electronic medical record system and inputs a query request, the query request is sent to the blockchain and the database, and the electronic medical record system obtains the corresponding sensitive data and common data through coding information in the query request, carries out integration on the obtained sensitive data and common data and displays the integrated data to the patient. When the method is implemented, the information of the patient can be shared and is convenient in obtaining, the information of the patient can be prevented from being tampered, and the rights of the patient can be guaranteed.