27 Feb The Hidden Threat: How Cybercriminals Exploit Fax Machines in Healthcare Operations

While modern cybersecurity focuses on digital threats like ransomware and phishing, an often-overlooked vulnerability in healthcare operations is the fax machine. Despite being considered outdated, fax machines remain widely used in healthcare due to HIPAA compliance concerns and the need to transmit medical records securely. However, cybercriminals have found ways to exploit these devices as entry points into medical networks.

How Fax Machines Become Cyber Threats

1. Unsecured Network Connections – Many modern fax machines are multifunction printers (MFPs) connected to a clinic’s internal network. If not properly secured, they can serve as a weak entry point for hackers.
2. Exploiting Analog-to-Digital Conversions – Attackers can manipulate fax protocols to execute code remotely. In 2018, researchers demonstrated how a maliciously crafted fax document could allow hackers to take control of networked fax machines.
3. Social Engineering via Fax Spoofing – Cybercriminals can send fraudulent faxes posing as insurance companies, vendors, or even government agencies, tricking staff into sharing sensitive patient information.
4. Data Interception – If faxes are transmitted over insecure VoIP (Voice over Internet Protocol) lines or stored in unprotected digital archives, they can be intercepted or accessed by unauthorized parties.

Mitigating the Risks

• Use Encrypted Digital Fax Services – Cloud-based fax solutions with end-to-end encryption are safer than traditional phone-line faxes.
• Isolate Fax Machines from Critical Networks – Keeping fax machines on a separate network segment prevents them from being exploited to access electronic medical records (EMR).
• Regular Firmware Updates – Ensure fax-enabled MFPs have up-to-date security patches to mitigate known vulnerabilities.
• Implement Strict Verification Protocols – Train staff to confirm the legitimacy of faxes before responding with sensitive information.

Though fax machines may seem like relics of the past, they remain embedded in healthcare operations. By understanding and addressing their security risks, hospitals, clinics and long-term care facilities can prevent cybercriminals from using these outdated devices as gateways to sensitive patient data.