CVE-2018-15154 in OpenEMR
Summary
by MITRE
OS command injection occurring in versions of OpenEMR before 5.0.1.4 allows a remote authenticated attacker to execute arbitrary commands by making a crafted request to interface/billing/sl_eob_search.php after modifying the "print_command" global variable in interface/super/edit_globals.php.
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Analysis
by VulDB Data Team • 05/02/2023
The vulnerability identified as CVE-2018-15154 represents a critical operating system command injection flaw within the OpenEMR electronic health record system. This vulnerability affects all versions prior to 5.0.1.4 and demonstrates a significant security weakness that allows remote authenticated attackers to execute arbitrary commands on the underlying system. The flaw specifically resides in the billing interface component of the application, making it particularly dangerous as it could be exploited by attackers who have already gained legitimate user access to the system.
The technical implementation of this vulnerability stems from improper input validation and sanitization within the OpenEMR application's global variable handling mechanism. Attackers can manipulate the "print_command" global variable located in the interface/super/edit_globals.php file to inject malicious commands that will be executed by the system. This occurs because the application fails to properly sanitize user-supplied input before incorporating it into system commands, creating an environment where attacker-controlled data can be interpreted as executable code rather than simple data.
The operational impact of this vulnerability extends far beyond simple command execution capabilities. Once exploited, an attacker can gain full control over the affected system, potentially leading to data breaches, system compromise, and unauthorized access to sensitive patient information. The vulnerability is particularly concerning because it requires only authenticated access to the system, meaning that an attacker who has obtained legitimate user credentials can leverage this flaw to escalate privileges and execute malicious commands with the privileges of the web application user. This represents a classic privilege escalation scenario that can result in complete system compromise and data exfiltration.
Security professionals should note that this vulnerability aligns with CWE-78, which specifically addresses OS command injection flaws in software applications. The attack pattern follows established methodologies described in the MITRE ATT&CK framework under the technique of command and control, where adversaries use legitimate system commands to maintain persistence and execute malicious activities. Organizations should prioritize immediate patching of affected systems to prevent exploitation, as the vulnerability exists in versions that were widely deployed in healthcare environments. The remediation process requires updating to OpenEMR version 5.0.1.4 or later, which includes proper input validation and sanitization measures to prevent command injection attacks. Additionally, implementing network segmentation and access controls can help limit the potential impact of such vulnerabilities by reducing the attack surface and preventing unauthorized access to critical system components.