Client: CHAI / PATH / National Department of Health
Partner: Dukstra Technologies
Date: May 2019 – November 2024

The Challenge

The TIER.net central system, responsible for managing over 13 million TB/HIV patient records, was experiencing severe performance degradation—particularly during dispatch uploads from large provinces like KwaZulu-Natal and Gauteng. Reports indicated long delays, slow response times, and challenges in concurrent access during peak loads. The original architecture, hosted on a single Hyper-V physical server, lacked resilience and scalability.

Dukstra’s Approach

Dukstra Technologies was contracted in May 2019 to assess, redesign, and support the centralized TIER.net environment. Our work began with a deep technical audit in collaboration with CHAI and Jembi Health Systems. We profiled both the system infrastructure and the TIER.net application to identify performance bottlenecks and inefficiencies.

Using an evidence-based and empirical methodology, Dukstra proposed architectural reconfiguration—including server separation, enhanced database management, and performance benchmarking.

The Solution

• Infrastructure Overhaul: Migrated from a single physical server to a multi-server architecture, isolating SQL operations and reporting functions to dedicated servers.

• Performance Tuning: Implemented profiling, database optimizations, and stress tests to benchmark old vs. new environments.

• High Availability & Reporting: Introduced a dedicated SQL reporting server to minimize contention and enable consistent uptime during dispatch uploads.

• Security Architecture: Reviewed and upgraded access controls, backups, and replication mechanisms in line with data protection and audit requirements.

The Impact

• Dispatch upload performance improved significantly, reducing latency and enabling faster data availability across provinces.

• Reporting functions remained online and responsive even during peak loads.

• The re-architected system proved robust enough to handle growing data volumes and user demands.

• PATH adopted Dukstra’s benchmark recommendations and funded the transition to the new platform.

Ongoing Value

Dukstra continues to support TIER.net infrastructure by:

• Ensuring uptime and disaster recovery readiness

• Updating server configurations and replication strategies

• Advising on future-proofing and capacity planning