CVE-2018-15148 in OpenEMR
Summary
by MITRE
SQL injection vulnerability in interface/patient_file/encounter/search_code.php in versions of OpenEMR before 5.0.1.4 allows a remote authenticated attacker to execute arbitrary SQL commands via the 'text' parameter.
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Analysis
by VulDB Data Team • 05/02/2023
The vulnerability identified as CVE-2018-15148 represents a critical SQL injection flaw within the OpenEMR healthcare information system platform. This vulnerability specifically affects versions prior to 5.0.1.4 and resides within the interface/patient_file/encounter/search_code.php file, which serves as a search interface for medical encounter codes. The flaw enables remote authenticated attackers to manipulate database queries through the 'text' parameter, potentially compromising the integrity and confidentiality of sensitive patient health information stored within the system. This type of vulnerability falls under the Common Weakness Enumeration category CWE-89, which specifically addresses SQL injection weaknesses in software applications.
The technical implementation of this vulnerability occurs when the application fails to properly sanitize user input before incorporating it into database queries. When an authenticated user submits data through the search interface, the 'text' parameter is directly concatenated into SQL commands without appropriate input validation or parameterization. This allows attackers to inject malicious SQL syntax that can alter the intended query execution path, potentially leading to unauthorized data access, modification, or deletion. The authenticated nature of the attack means that an attacker must first obtain valid credentials, but once inside the system, they can leverage this vulnerability to escalate their privileges and access sensitive medical records.
The operational impact of this vulnerability extends beyond simple data theft, as healthcare organizations face significant regulatory and compliance risks when patient data is compromised. The exposure of medical records through SQL injection attacks can result in violations of healthcare privacy regulations such as HIPAA, potentially leading to substantial financial penalties and reputational damage. Additionally, the vulnerability can be exploited to manipulate patient encounter data, alter medical histories, or gain access to administrative functions within the system. According to the MITRE ATT&CK framework, this vulnerability maps to the technique T1071.004 for application layer protocol and T1046 for network service scanning, as attackers can use this flaw to explore and map the database structure.
Organizations should implement immediate mitigations including upgrading to OpenEMR version 5.0.1.4 or later, which contains the necessary patches to address this vulnerability. Additionally, implementing proper input validation and parameterized queries within the application code can provide defense-in-depth protection against similar issues. Database access controls should be reviewed to ensure that application accounts have minimal necessary privileges, and regular security assessments should be conducted to identify and remediate potential injection points throughout the application. Network segmentation and intrusion detection systems can help monitor for suspicious database access patterns that might indicate exploitation attempts. The vulnerability highlights the critical importance of maintaining up-to-date software versions and implementing robust input sanitization practices as recommended by security frameworks such as the OWASP Top Ten and NIST cybersecurity guidelines.