CVE-2026-25930 Overview
OpenEMR is a free and open source electronic health records and medical practice management application. A significant Insecure Direct Object Reference (IDOR) vulnerability exists in the Layout-Based Form (LBF) printable view component. Prior to version 8.0.0, the application accepts formid and visitid (or patientid) parameters from HTTP requests without properly verifying that the requested form belongs to the current user's authorized patient or encounter. This authorization bypass allows authenticated users with LBF access to enumerate form IDs and view or print any patient's encounter forms, potentially exposing sensitive protected health information (PHI).
Critical Impact
Authenticated attackers can access and exfiltrate sensitive patient medical records by exploiting the authorization bypass in the Layout-Based Form printable view, potentially leading to HIPAA violations and patient privacy breaches.
Affected Products
- OpenEMR versions prior to 8.0.0
- OpenEMR installations with Layout-Based Forms (LBF) functionality enabled
- Healthcare organizations using OpenEMR for electronic health records management
Discovery Timeline
- 2026-02-25 - CVE-2026-25930 published to NVD
- 2026-02-25 - Last updated in NVD database
Technical Details for CVE-2026-25930
Vulnerability Analysis
This vulnerability is classified as CWE-639: Authorization Bypass Through User-Controlled Key, a form of Insecure Direct Object Reference (IDOR). The flaw resides in the interface/forms/LBF/printable.php file, which handles the rendering of printable versions of Layout-Based Forms. The vulnerable code path directly uses user-supplied parameters (formid, visitid, or patientid) to retrieve form data without performing adequate authorization checks to verify that the requesting user has legitimate access to the specified patient's records.
An authenticated attacker with basic LBF access can manipulate these parameters to access forms belonging to other patients. By systematically enumerating form IDs, an attacker could potentially access the entire patient database's encounter forms, leading to massive unauthorized disclosure of protected health information.
Root Cause
The root cause of this vulnerability is missing authorization validation in the Layout-Based Form printable view functionality. The application fails to verify the relationship between the authenticated user's access permissions and the patient/encounter data being requested. The formid and visitid/patientid parameters are trusted directly from user input without cross-referencing against the current user's authorized patient list.
Attack Vector
The attack is network-based and requires authentication. An attacker with legitimate but limited access to OpenEMR can exploit this vulnerability by:
- Authenticating to the OpenEMR application with valid credentials
- Navigating to the LBF printable view endpoint
- Manipulating the formid and visitid or patientid parameters in the request
- Enumerating form IDs sequentially or through targeted guessing
- Viewing or printing encounter forms belonging to patients they are not authorized to access
* @author Rod Roark <rod@sunsetsystems.com>
* @author Brady Miller <brady.g.miller@gmail.com>
* @author Sherwin Gaddis <sherwingaddis@gmail.com> contributed the header and footer only
+ * @author Michael A. Smith <michael@opencoreemr.com>
* @copyright Copyright (c) 2009-2019 Rod Roark <rod@sunsetsystems.com>
* @copyright Copyright (c) 2019 Brady Miller <brady.g.miller@gmail.com>
* @copyright Copyright (c) 2019 Sherwin Gaddis <sherwingaddis@gmail.com>
+ * @copyright Copyright (c) 2026 OpenCoreEMR Inc <https://opencoreemr.com/>
* @license https://github.com/openemr/openemr/blob/master/LICENSE GNU General Public License 3
*/
Source: GitHub Commit
Detection Methods for CVE-2026-25930
Indicators of Compromise
- Unusual access patterns to interface/forms/LBF/printable.php with varying formid parameters from a single user session
- Sequential or bulk requests to the LBF printable view endpoint indicating form ID enumeration attempts
- Access logs showing users viewing patient forms outside their assigned patient population
- Audit trail anomalies where users access encounter forms for patients they have no clinical relationship with
Detection Strategies
- Implement application-level logging that captures the relationship between requesting user and accessed patient records
- Monitor for high-volume requests to the LBF printable endpoint from individual user sessions
- Deploy web application firewall (WAF) rules to detect parameter manipulation and sequential ID enumeration patterns
- Correlate user access patterns with their authorized patient assignments to identify unauthorized access attempts
Monitoring Recommendations
- Enable comprehensive audit logging for all patient record access in OpenEMR
- Configure alerts for users accessing abnormally high numbers of distinct patient records
- Review access logs regularly for patterns consistent with IDOR exploitation
- Implement real-time monitoring for the printable.php endpoint with alerting on suspicious parameter patterns
How to Mitigate CVE-2026-25930
Immediate Actions Required
- Upgrade OpenEMR to version 8.0.0 or later immediately
- Audit access logs for evidence of exploitation prior to patching
- Review user permissions and restrict LBF access to only necessary personnel
- Implement network-level access controls to limit exposure of the OpenEMR application
Patch Information
OpenEMR has addressed this vulnerability in version 8.0.0. The fix implements proper authorization checks to verify that the authenticated user has legitimate access to the patient and encounter data being requested through the LBF printable view. Organizations should upgrade to version 8.0.0 or apply the security patch from commit 8c76acdd226007cc4ff3eccd3ca6193e0be6e699. For detailed information, refer to the GitHub Security Advisory and the security patch commit.
Workarounds
- Restrict access to the LBF functionality through role-based access controls until patching is possible
- Implement additional authentication requirements for accessing the printable view endpoint
- Deploy a web application firewall rule to block requests with manipulated formid or visitid parameters
- Temporarily disable the LBF printable view functionality if not business-critical
# Configuration example - Apache mod_rewrite to restrict LBF printable access
# Add to .htaccess or Apache configuration
<Location /interface/forms/LBF/printable.php>
# Restrict access to specific IP ranges or require additional authentication
Require ip 10.0.0.0/8
Require ip 192.168.0.0/16
</Location>
Disclaimer: This content was generated using AI. While we strive for accuracy, please verify critical information with official sources.
