Purpose/Significance To explore a cross-level medical data collaboration mechanism in the Yangtze River Delta featuring hierarchical rights and responsibilities, system adaptation, and technology integration, in order to systematically address the challenges such as standard fragmentation, lack of incentives, and privacy conflicts in medical data collaboration. Method/Process A dual-core collaborative model of federal governance × smart contract is proposed, including three levels:overall design, mechanism setting (soft management), and technical setting (hard technology), then a cross-level medical data collaborative mechanism model for the Yangtze River Delta is constructed. Result/Conclusion The model can promote the efficient circulation and value release of medical data, providing a “Yangtze River Delta scheme” for regional collaboration of medical data.