Centralized support user management in a distributed healthcare information management system. Support user management may include generation of permission data that may be distributed from a central server to one or more local systems. The local systems may execute a healthcare information management application such as, for example, a pharmacy workflow management application. In any regard, central support users at the central server may periodically require access to the local systems to perform, among other activities, technical support or troubleshooting in relation to the application executed at the local system. In turn, provision of permission data from the central server to the local system may allow support users to access the local system with specific permission identification's provided specific ones of the support users. In turn, specific user permissions may be established and support user tracking may be carried out at the local systems.