Most trusted systems allow you to set up kernel enforced append only files. If you are on Solaris you could use Trusted Extensions or PitBull Foundation. AIX also has a trusted version (PitBull on 5.x). A lot of the other HIPAA requirements are met by features that come along with a trusted OS like SELinux/TS/PitBull. These platform based solutions aren't widely known about, and thus not used very much...but they do work.
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Most trusted systems allow you to set up kernel enforced append only files. If you are on Solaris you could use Trusted Extensions or PitBull Foundation. AIX also has a trusted version (PitBull on 5.x). A lot of the other HIPAA requirements are met by features that come along with a trusted OS like SELinux/TS/PitBull. These platform based solutions aren't widely known about, and thus not used very much...but they do work.