CVE-2026-24487
📋 TL;DR
OpenEMR versions before 8.0.0 have an authorization bypass vulnerability in the FHIR CareTeam endpoint that allows patient-scoped tokens to access care team data for all patients instead of just the authenticated patient's data. This affects all OpenEMR installations using FHIR APIs with patient-scoped tokens, potentially exposing Protected Health Information (PHI) across the entire system.
💻 Affected Systems
- OpenEMR
📦 What is this software?
Openemr by Open Emr
⚠️ Risk & Real-World Impact
Worst Case
Complete disclosure of all patient-provider relationships and care team structures across the entire healthcare organization, violating HIPAA regulations and exposing sensitive PHI to unauthorized parties.
Likely Case
Unauthorized access to patient care team information for multiple patients, potentially revealing treatment relationships and care coordination details that should remain confidential.
If Mitigated
Limited exposure if proper network segmentation, API gateway controls, and monitoring are in place to detect anomalous access patterns.
🎯 Exploit Status
Exploitation requires a valid patient-scoped FHIR token, but once obtained, the bypass is straightforward as it involves accessing the CareTeam endpoint without proper patient compartment filtering.
🛠️ Fix & Mitigation
✅ Official Fix
Patch Version: 8.0.0
Vendor Advisory: https://github.com/openemr/openemr/security/advisories/GHSA-4frq-f657-hwrc
Restart Required: Yes
Instructions:
1. Backup your OpenEMR installation and database. 2. Download OpenEMR version 8.0.0 or later from the official repository. 3. Follow the OpenEMR upgrade documentation for your specific deployment method. 4. Apply the patch by updating to version 8.0.0 or later. 5. Restart the web server and verify the upgrade was successful.
🔧 Temporary Workarounds
Disable FHIR CareTeam Endpoint
allTemporarily disable the vulnerable FHIR CareTeam endpoint until patching can be completed.
# Modify OpenEMR configuration to disable FHIR CareTeam resource
# Edit the FHIR configuration file to remove or restrict CareTeam endpoint access
Implement API Gateway Controls
linuxDeploy an API gateway or WAF to restrict and monitor FHIR API access patterns.
# Configure rate limiting and access controls for /fhir/CareTeam endpoints
# Example for nginx:
# location /fhir/CareTeam { deny all; }
🧯 If You Can't Patch
- Implement strict network segmentation to isolate FHIR APIs from untrusted networks
- Enable detailed logging and monitoring of all FHIR CareTeam endpoint access and set up alerts for anomalous patterns
🔍 How to Verify
Check if Vulnerable:
Check if your OpenEMR version is below 8.0.0 and if FHIR APIs are enabled. Test with a patient-scoped token to see if you can access CareTeam data for patients other than the token owner.Check Version:
Check the OpenEMR interface or database for version information, or examine the codebase for version markers.Verify Fix Applied:
After upgrading to 8.0.0 or later, verify that patient-scoped tokens can only access their own CareTeam data and receive proper authorization errors when attempting to access other patients' data.📡 Detection & Monitoring
Log Indicators:
- Multiple CareTeam resource accesses from single patient token in short time
- Access denied errors for CareTeam endpoints after patch
- Unusual patterns of FHIR API calls to CareTeam resources
Network Indicators:
- High volume of requests to /fhir/CareTeam endpoints
- Requests with patient tokens accessing sequential patient IDs
SIEM Query:
source="openemr_logs" AND (uri_path="/fhir/CareTeam" OR endpoint="CareTeam") | stats count by patient_token, patient_id | where count > threshold