I had the pleasure of talking to folks from the University of IA about their current implementation of SMS 2003. SMS 2003 is a central part of their systems management process they call "Enterprise Client Management". More information about their setup can be found here: http://spa.its.uiowa.edu/ecm/.
What really makes their implementation great is that it does span multiple, independent departments at the University - a very common situation among big Universities. They are able to effectively use SMS as a central service yet allow delegated tasks to these departments. Chris Blasen is the manager of this solution (his contact info can be found on the web page I reference) and has done an excellent job with SMS at UIowa!