Tautomerism happens all the time. A simple example would be an acid catalyzed aldol reaction where the acid causes a shift in the equilibrium toward the enol form, and that in turn attacks an aldehyde. There are other examples like the equilibrium of ring closed and ring open lactols. In some cases you can trap out the ring open form for carbonyl reactions such as Wittig olefination. Each of these has been used in synthesis many times.
The mechanism of tautomerization is definitely debatable. In principle, it could be unimolecular, so in the case of keto-enol tautomerism, the proton could just slip along the pi system. However, you could think of a mechanism where two ketones come into close proximity to one another and then deprotonate one another in an eight membered ring transition state. At any rate, it's very difficult to observe this mechanism.