CVE-2015-4593 in Population Health
Summary
by MITRE
eClinicalWorks Population Health (CCMR) suffers from a cross-site request forgery (CSRF) vulnerability in portalUserService.jsp which allows remote attackers to hijack the authentication of content administrators for requests that could lead to the creation, modification and deletion of users, appointments and employees.
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Analysis
by VulDB Data Team • 04/20/2025
The vulnerability identified as CVE-2015-4593 resides within eClinicalWorks Population Health CCMR software, specifically in the portalUserService.jsp component. This cross-site request forgery vulnerability represents a critical security flaw that undermines the integrity of the authentication mechanism and exposes administrative functions to unauthorized manipulation. The flaw allows remote attackers to exploit the system's trust in authenticated sessions by crafting malicious requests that appear legitimate to the application's backend services. The vulnerability specifically targets content administrators who possess elevated privileges within the system, making the potential impact significantly more severe than typical CSRF attacks that might affect regular users.
The technical implementation of this CSRF vulnerability stems from the absence of proper request validation mechanisms within the portalUserService.jsp endpoint. When administrators perform administrative tasks such as creating new users, modifying existing user accounts, deleting appointments, or managing employee records, the system fails to verify that these requests originate from legitimate administrative sessions. This absence of anti-CSRF tokens or session validation allows attackers to construct malicious web pages or exploit existing vulnerabilities in web browsers to automatically submit requests that execute with the administrator's privileges. The vulnerability operates at the application layer and leverages the trust relationship between the web application and authenticated users, effectively bypassing traditional authentication controls.
From an operational standpoint, the impact of this CSRF vulnerability extends far beyond simple data manipulation. Attackers who successfully exploit this flaw can fundamentally alter the user access control model within the system, potentially creating new administrator accounts, modifying existing user permissions, deleting critical appointment data, or manipulating employee records. The consequences include unauthorized data modification, potential data loss, disruption of healthcare services, and compromise of patient information integrity. The vulnerability particularly threatens healthcare organizations that rely on eClinicalWorks for population health management, as it could lead to unauthorized access to sensitive medical records and disruption of critical healthcare operations. Organizations may experience regulatory compliance violations under healthcare privacy laws such as HIPAA due to the exposure of unauthorized data access and modification capabilities.
Mitigation strategies for this CSRF vulnerability should encompass multiple layers of defense to protect against exploitation. The primary remediation involves implementing robust anti-CSRF token mechanisms within the portalUserService.jsp endpoint, ensuring that each administrative request contains a unique, unpredictable token that validates the authenticity of the session. Additionally, organizations should enforce proper session management practices including session timeout mechanisms, secure cookie attributes, and regular session validation checks. The implementation of content security policies and proper input validation can further reduce the attack surface. According to CWE guidelines, this vulnerability maps to CWE-352, which specifically addresses cross-site request forgery weaknesses. From an ATT&CK framework perspective, this vulnerability aligns with techniques such as T1566.001 (Phishing) for initial access and T1078 (Valid Accounts) for privilege escalation. Organizations should also consider implementing web application firewalls, conducting regular security assessments, and ensuring proper network segmentation to limit the potential impact of successful exploitation. The remediation process should include comprehensive testing to verify that all administrative endpoints properly validate requests and that no similar CSRF vulnerabilities exist within the application's attack surface.