I'd prefer that VATS either be paused, or actually useful against anything further away than 30 feet without using a critical shot.
As is it's far less accurate than actually aiming if the enemy is outside of flamethrower range, so there's barely any reason to use it if you aren't being charged by enemies.
if you 'are' being charged by enemies, it doesn't actually slow time enough to easily manage the UI to target what you wanted anyways (Unless what you wanted was to shoot them center mass, the default targeting location).
Either the enemy is nearby and you can just shoot it in the face normally, or it's far away and VATS is only good for critical shots and wasting ammo.
As far as modding goes, once the GECK is here it'd probably be trivial to change the time dilation to a tenth of a percent or something, which is close enough to paused that you'd have to wander afk for it to matter.