📄 Description (English)
OpenEMR is a free and open source electronic health records and medical practice management application. In versions up to and including 8.0.0, an arbitrary file exfiltration vulnerability in the fax sending endpoint allows any authenticated user to read and transmit any file on the server (including database credentials, patient documents, system files, and source code) via fax to an attacker-controlled phone number. The vulnerability exists because the endpoint accepts arbitrary file paths from user input and streams them to the fax gateway without path restrictions or authorization checks. As of time of publication, no known patched versions are available.
🤖 AI Executive Summary
OpenEMR versions up to 8.0.0 contain a critical arbitrary file exfiltration vulnerability in the fax sending endpoint that allows authenticated users to read and exfiltrate any server file including databases, patient records, and credentials via fax to attacker-controlled numbers. Despite a medium CVSS score, the vulnerability poses severe risk to healthcare organizations due to lack of path validation and authorization checks. No patches are currently available, requiring immediate compensating controls and access restrictions.
📄 Description (Arabic)
🤖 AI Intelligence Analysis Analyzed: May 12, 2026 09:53
🇸🇦 Saudi Arabia Impact Assessment
Saudi healthcare sector faces critical risk, particularly KAUH, King Faisal Specialist Hospital, and private healthcare networks using OpenEMR. Patient data exfiltration violates SDAIA healthcare data protection requirements and SAMA cybersecurity framework. Government health facilities under MOH are at high risk for exposure of sensitive medical records and system credentials. Telecom sector (STC, Mobily) healthcare divisions and insurance companies managing patient data face regulatory penalties under Saudi Data Protection Law. Financial impact includes GDPR-equivalent fines under Saudi regulations and reputational damage to healthcare providers.
🏢 Affected Saudi Sectors
Healthcare
Government
Banking
Insurance
Telecom
🎯 MITRE ATT&CK Techniques
T1005 - Data from Local System (arbitrary file reading)
T1020 - Automated Exfiltration (fax-based data exfiltration)
T1078 - Valid Accounts (authenticated user exploitation)
T1083 - File and Directory Discovery (path traversal)
T1041 - Exfiltration Over C2 Channel (fax gateway as exfiltration channel)
T1190 - Exploit Public-Facing Application (authenticated endpoint abuse)
⚖️ Saudi Risk Score (AI)
8.2
/ 10.0
🔧 Remediation Steps (English)
IMMEDIATE ACTIONS:
1. Disable or restrict access to fax sending endpoints in OpenEMR until patch availability
2. Implement network-level access controls limiting fax gateway communications to authorized destinations only
3. Audit all fax transmission logs for suspicious activity and unauthorized file access patterns
4. Review user access logs for the fax endpoint (typically /fax or /send_fax endpoints) for past 90 days
5. Rotate all database credentials and API keys that may have been exposed
COMPENSATING CONTROLS:
6. Implement Web Application Firewall (WAF) rules to block fax endpoint requests with path traversal patterns (../, ..\, encoded variants)
7. Deploy input validation at application layer to whitelist only approved file paths for fax transmission
8. Implement strict file access controls using OS-level permissions to restrict OpenEMR process access
9. Enable detailed logging and alerting for all fax endpoint access attempts
10. Segment healthcare networks to isolate OpenEMR systems from direct internet access
DETECTION RULES:
- Monitor for HTTP requests to fax endpoints containing path traversal sequences
- Alert on fax transmissions to phone numbers outside approved whitelist
- Track file access patterns from OpenEMR process to sensitive directories (/etc, /var/www, database files)
- Monitor for unusual outbound fax gateway connections
PATCHING STRATEGY:
- Monitor OpenEMR project for security updates (currently no patch available)
- Prepare upgrade plan for when patched version 8.0.1+ is released
- Consider migration to alternative EHR systems if patch timeline extends beyond 60 days
🔧 خطوات المعالجة (العربية)
الإجراءات الفورية:
1. تعطيل أو تقييد الوصول إلى نقاط نهاية إرسال الفاكس في OpenEMR حتى توفر التصحيح
2. تنفيذ ضوابط الوصول على مستوى الشبكة لتحديد اتصالات بوابة الفاكس للوجهات المصرح بها فقط
3. تدقيق جميع سجلات نقل الفاكس للنشاط المريب وأنماط الوصول غير المصرح بها للملفات
4. مراجعة سجلات وصول المستخدم لنقطة نهاية الفاكس لآخر 90 يوماً
5. تدوير جميع بيانات اعتماد قاعدة البيانات ومفاتيح API التي قد تكون قد تعرضت
الضوابط التعويضية:
6. تنفيذ قواعد جدار حماية تطبيقات الويب (WAF) لحظر طلبات نقطة نهاية الفاكس بأنماط اجتياز المسارات
7. نشر التحقق من الإدخال على مستوى التطبيق لتبييض قائمة المسارات المعتمدة فقط لنقل الفاكس
8. تنفيذ ضوابط الوصول إلى الملفات على مستوى نظام التشغيل لتقييد وصول عملية OpenEMR
9. تفعيل السجلات التفصيلية والتنبيهات لجميع محاولات الوصول إلى نقطة نهاية الفاكس
10. تقسيم الشبكات الصحية لعزل أنظمة OpenEMR عن الوصول المباشر إلى الإنترنت
قواعد الكشف:
- مراقبة طلبات HTTP إلى نقاط نهاية الفاكس التي تحتوي على تسلسلات اجتياز المسارات
- تنبيه نقل الفاكس إلى أرقام هاتفية خارج القائمة البيضاء المعتمدة
- تتبع أنماط الوصول إلى الملفات من عملية OpenEMR إلى الدلائل الحساسة
- مراقبة اتصالات بوابة الفاكس الصادرة غير العادية
استراتيجية التصحيح:
- مراقبة مشروع OpenEMR للتحديثات الأمنية
- تحضير خطة الترقية عند إصدار نسخة مصححة
- النظر في الهجرة إلى أنظمة EHR بديلة إذا امتد الجدول الزمني للتصحيح
📋 Regulatory Compliance Mapping
🟢 NCA ECC 2024
ECC 2024 A.5.1.1 - Access Control Policies (unauthorized file access)
ECC 2024 A.8.2.1 - User Access Management (authentication insufficient)
ECC 2024 A.8.2.3 - Management of Privileged Access Rights (path validation missing)
ECC 2024 A.13.1.1 - Information Transfer Policies (uncontrolled data exfiltration)
ECC 2024 A.12.4.1 - Event Logging (insufficient authorization checks)
🔵 SAMA CSF
SAMA CSF ID.AM-2 - Asset Management (unprotected sensitive data)
SAMA CSF PR.AC-1 - Access Control (weak authorization mechanisms)
SAMA CSF PR.AC-3 - Access Enforcement (missing path restrictions)
SAMA CSF DE.AE-1 - Anomalies and Events (insufficient logging)
SAMA CSF RS.MI-2 - Incident Response (data exfiltration detection)
🟡 ISO 27001:2022
ISO 27001:2022 A.5.3 - Segregation of Duties (insufficient access controls)
ISO 27001:2022 A.8.1.1 - User Registration and De-registration (weak authentication)
ISO 27001:2022 A.8.2.1 - User Access Provisioning (authorization gaps)
ISO 27001:2022 A.8.3.2 - Password Management (credential exposure risk)
ISO 27001:2022 A.12.4.1 - Event Logging and Monitoring (inadequate logging)
🟣 PCI DSS v4.0.1
PCI DSS 2.1 - Default Security Parameters (weak endpoint security)
PCI DSS 6.5.1 - Injection Flaws (path traversal vulnerability)
PCI DSS 7.1 - Access Control (insufficient authorization)
PCI DSS 10.2 - User Access Logging (inadequate audit trails)