In June 2023, UTHealth Houston launched iDFax, a solution powered by Amazon Bedrock, to transform medical fax management. Clinical staff had spent up to 2.5 minutes on a single medical fax, reviewing, categorizing, routing, and manually entering data into their electronic health record system. What began as a pilot processing 2,800 faxes monthly scaled to an enterprise deployment handling over 100,000 faxes monthly by February 2026, representing an approximately 3,500% increase in processing volume over 32 months. At full deployment, iDFax processes more than 1.2 million faxes annually across UT Physicians clinics, with over 1,200 registered users across more than 100 clinics. The system achieved more than $2 million in annual cost savings through processing time reductions and workflow automation, while maintaining more than 95% optical character recognition accuracy. Processing times were reduced by 50–70%, from 82–150 seconds per fax to only 28–68 seconds. The solution maintained strict Health Insurance Portability and Accountability Act compliance throughout the 2-year journey from pilot to enterprise-scale production.