Insecure Direct Object Reference in OpenEMR rx_print.php Printer Exposes Patient Prescriptions

Executive Summary

OpenEMR before version 8.5.0 has an insecure direct object reference (IDOR) vulnerability in the CAMOS rx_print.php printer. Authenticated users can exploit this by submitting forged parameters with global prescription IDs to access and read other patients' prescriptions without proper authorization.

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Detection Guidance

To detect this vulnerability, monitor for unauthorized access to the CAMOS rx_print.php endpoint. Check server logs for requests containing forged chrx_ parameters with global prescription IDs. Look for repeated attempts to access prescriptions not belonging to the authenticated user.

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Impact Analysis

This vulnerability allows attackers with authenticated access to view sensitive prescription details of other patients, including drug names, dosages, directions, and refill counts. This could lead to privacy breaches, misuse of medical information, or unauthorized disclosure of health data.

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Compliance Impact

This vulnerability likely violates privacy regulations like GDPR and HIPAA by enabling unauthorized access to protected health information. It compromises patient confidentiality and could result in legal penalties, reputational damage, and loss of trust in healthcare systems.

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Mitigation Strategies

Immediately upgrade OpenEMR to version 8.5.0 or later. Implement server-side validation to ensure users can only access their own prescriptions. Enforce strict access controls and use allowlists for prescription IDs to prevent unauthorized access.

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