In the blockchain network constructed by the Practical Byzantine Fault Tolerance (PBFT), there are problems that the master node needs to be replaced frequently when the master node and the sub-node break down, and the same information is verified multiple times when the sub-node does not work normally. In response to these problems, the award and penalty mechanism is applied to the PBFT consensus algorithm and supervision nodes are introduced to supervise the master node and the sub-node in the blockchain network. Construct a tripartite evolutionary game model with the master node, suspected sub-node and supervision node as the main body to analyze the changes of the three in reaching the three stable states of normal information transmission, normal information verification, and supervision of other nodes before and after the improvement of the PBFT consensus algorithm, and use Matlab software for simulation calculation. The research result proves that the application of the award and penalty mechanism to the PBFT algorithm can improve the efficiency of the master node and the suspected sub-node in normal information transmission and normal information verification in the blockchain network. And it can also increase the participation proactivity of the master node and the suspected sub-node in information verification and the running for the master node. At the same time, increasing the system reward and the reward value, penalty value, and punishment credit value based on the award and penalty mechanism will also improve their efficiency of reaching normal information transmission and normal information verification, and ultimately ensures that the constructed blockchain network can efficiently achieve the goals of information verification and active participation of nodes in verification.

In view of the current development trend of the smart medical industry in the context of the internet of things, this study conducts an evolutionary game analysis on information technology providers, medical institutions, digital medical equipment providers, and medical regulatory agencies in the smart medical industry. This study also analyzes the stable state of the future development of the smart medical industry and performs simulation calculations through MATLAB software. The research results show that the overall development trend of the smart medical industry structure in the future is consistent with the development trend of each industry structure. Under the strategic background of the supervision of medical regulatory agencies, information technology providers and digital medical equipment providers, respectively, provide the smart medical industry with the latest information technology and digital medical equipment to ensure the technical support of the smart medical industry. The smart medical industry provides corresponding medical talents and medical equipment to ensure the demand for talents and equipment of the smart medical industry, so that the structure of the smart medical industry can continuously improve the level of smart medical technology in the future development and ultimately promote the overall development of the smart medical industry.

This paper introduces the application of blockchain technology in the field of IoT medical information, proposes a secure and trustworthy framework for storing and sharing medical information based on blockchain, containing functions such as tamper‐proof storage of IoT medical data, desensitization processing of sensitive information and sharing of medical information security, and predicts the future market state transfer and the construction time of the model framework from the perspective of economics.