CVE-2026-124475 in OpenEMR
Summary
by MITRE • 11/08/2026
OpenEMR before 8.3.0 contains an insecure direct object reference vulnerability in portal/lib/persist.php that allows authenticated portal patients to modify other patients' settings by supplying an arbitrary setting_patient value. Attackers can insert or overwrite patient_settings rows for victims to suppress notifications, tamper with consent flags, or alter portal preferences.
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Analysis
by VulDB Data Team • 11/08/2026
The identified security flaw resides within the OpenEMR healthcare management platform prior to version 8.3.0 and is classified as an Insecure Direct Object Reference vulnerability located in the file portal/lib/persist.php. This type of vulnerability arises when a web application uses user-supplied input, such as an identifier or key, to directly access objects like database records without performing adequate authorization checks on whether that specific user has permission to modify the targeted object. In this specific instance, the system fails to validate that the patient ID provided in the request corresponds to the account of the currently authenticated user attempting to make changes. Consequently, any authenticated portal patient can manipulate the setting_patient parameter to target arbitrary records belonging to other patients within the database.
From a technical perspective, the vulnerability allows an attacker who has valid credentials for one patient account to send crafted HTTP requests that specify different values for the setting_patient field. Because the backend logic relies on this input to determine which record to update without cross-referencing it against the session's authenticated user identity or performing explicit access control verification, the application blindly executes the modification operation. This lack of object-level authorization enables the attacker to insert new rows into the patient_settings table or overwrite existing ones for victims who are not associated with the attacker's account. The persistence layer accepts these inputs and commits them to the database, effectively bypassing the intended isolation between different patients' data sets within the multi-tenant architecture of the electronic health record system.
The operational impact of this vulnerability is significant due to the sensitive nature of healthcare data and patient privacy regulations such as HIPAA in the United States or GDPR in Europe. By exploiting this flaw, an attacker can suppress critical notifications intended for other patients, potentially causing them to miss important medical reminders, appointment alerts, or security warnings. Furthermore, tampering with consent flags poses a severe risk to patient autonomy and legal compliance; attackers could alter permissions regarding data sharing, research participation, or access by third-party providers without the victim's knowledge or consent. Additionally, altering portal preferences can disrupt the user experience for victims, potentially locking them out of certain features or exposing their personal health information through misconfigured privacy settings. This represents a breach of confidentiality and integrity within the healthcare ecosystem.
This vulnerability aligns with CWE-639, which describes Insecure Direct Object References, where an application exposes a reference to an internal implementation object, such as a file, directory, or database key, without proper access control checks. It also maps to MITRE ATT&CK technique T1078, specifically Valid Accounts, as the exploitation requires initial authentication but leverages flawed authorization logic rather than credential theft. The attack vector is classified under Remote Code Execution principles in terms of data manipulation, though more accurately it falls under Data Injection and Access Control Bypass categories within healthcare-specific threat models.
To mitigate this vulnerability, organizations running OpenEMR versions prior to 8.3.0 should immediately upgrade to version 8.3.0 or later where the issue has been resolved by implementing proper authorization checks in the persist.php module. The fix ensures that any request modifying patient settings verifies that the setting_patient ID matches the authenticated user's account identifier before proceeding with database operations. In environments where immediate patching is not feasible, administrators should implement a Web Application Firewall rule to monitor and restrict unusual patterns of requests targeting the portal/lib/persist.php endpoint, particularly those involving rapid changes to different patient IDs from a single session. Additionally, enforcing strict input validation on all parameters passed to backend services and conducting regular code reviews focused on access control logic can help prevent similar insecure direct object reference flaws in other parts of the application infrastructure.