The sustainable development of medical data sharing necessitates data governance and management frameworks and systems that are grounded in the fundamental elements and tailored to specific objectives corresponding to the challenges in this field. We propose that data and stakeholders are the fundamental elements of medical data sharing and application. Multilevel frameworks and systems are designed based on the general principles of effective governance and considering the three relationships established between data and stakeholders, along with data governance objectives. We address key issues and propose governance and management mechanisms and rules for medical data sharing and application, and emphasize on clarifying the medical data processing rules as sensitive personal information, particularly on the systemic institutional data systems we constructed.