Big data holds significant promise for transforming healthcare, enabling enhanced medical research, preventive care, and personalized medicine. However, realizing these benefits depends on healthcare organizations' ability to produce exploitable data—data that is high-quality, standardized, interoperable, and accessible. While prior research has identified the capabilities required for big data use, little is known about how these capabilities interact in practice to make data exploitable. This study investigates how healthcare organizations develop exploitable big data by examining the dynamic interplay among governance, human, and technical capabilities. Drawing on an ethnographic study of the Health Big Data (HBD) project, we identified four patterns of capability interaction each shaping specific properties of exploitable data. Our findings contribute to dynamic capability theory by offering a process-oriented view of capability interplay and revealing the evolving role of governance, as an initiator, mediator, and outcome of interaction. We also provide guidance for healthcare organizations to develop big data capabilities, foster stakeholder engagement, and enhance big data exploitability.