how to design an IHE audit trail repository ?

If you want to implement an IHE audit trail repository means that you must provide a syslog
compatible entry point. Note that the syslog entry point must implement the COOKED and RAW syslog profiles of RFC-3195.
These protocols are built on top of BEEP (see the vortex library for LGPL C library).

Storing the Audit trails must be designed to host the messages as described by RFC-3881 though, a database seems to be the best choice: access to the data can be monitored and searched effectively.

Once the storage and protocols are implemented, one should now think about security and error recovery this is the real challenge.

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