I'll explain, put on your reading glasses because this is going to be a long one.
Typically for those that are unexperienced with coal the first thing they think of is some sweaty guy in the depths of hell shoveling coal into some medieval looking monstrosity. They think of billowing black smoke, dirt and dust etc. That's not the case with anthracite coal and a "modern" stoker. Modern is in quotes because these designs have been around for more than half a century. That's not to say its perfectly clean, there is some dust involved with moving the ashes and the coal but this can for the most part be eliminated with caution and taking a few minor steps like dampening the coal before moving it. Isolation of a large boiler eliminates the dust problem all together, smaller stokers mean for inside the living space will be the most problematic. Overall from the consensus i gather from my forum members that have used wood or wood pellets in the past its not any more dirty that using either of those.
Bituminous coal found in Western Pennsylvania and just about every other state in the U.S. can resemble that description, it does produce a lot of smoke, soot and a powerful sulfury odor. What we are discussing here is anthracite coal which is the highest rank of coal. It's nearly 100% carbon. On the North American continent its only mined in Northeastern Pennsylvania, there are only a few other places in the world this type of coal is found. It burns with a bright bluish flame, cleanly without any smoke and you'll never smell it unless you get close to the top of your chimney. This makes it ideal for home heating. Fuel for residential and to some extent commercial heating is its primary use, it's also used as a medium for water filtration among other things.

Environmentally speaking the CO emissions are slightly greater than even Bituminous coal in a laboratory environment however unlike bituminous coal other emissions are very low and rival those of oil and gas and in some cases are below them. I'm just mentioning this for the benefit of those that are ultra environmentally conscious (although I think you're nuts

) because I don't want to give the impression that it does not produce the "dreaded" CO2 when I say it burns cleanly. That's really for another debate anyway and there are many other factors involved other than raw laboratory data.
Getting back to its use Anthracite coal is quite easy to manage and use, that's one of the benefits. There's two distinct types of units, stokers and hand fired stove. Stokers are the most popular type because these are automatic. They are not much different than any conventional heating system. Hand fired units are quite popular too and would be more like using a wood stove. Each has their advantages and disadvantages.
The stokers internally pretty much haven't changed in years, they are time tested design that work. There's really nothing to improve, they run around 80% efficiency but as high as 90%. You can't make it 100% because you need some heat escaping to maintain the draft in the chimney to pull the gases out.
There are three basic designs used in stoker units. One is auger fed with a firepot, there is the anthratube design and lastly the most common in smaller stokers the bed design. They all rely on the same principle, they force air through the coal. This is the boiler that's been in our basement for 25 years, it will be there for at least another 25. They are that durable.

As you can see other than the two doors on the front it looks no different than any furnace. This boiler uses an auger and firepot design, It's the Cadillac of coal furnaces. You'll notice the wood bin behind it, that space will hold enough coal to heat our 4000 sq foot home for about 1 year. Not shown is the auger, this is a pipe that comes out of the furnace into the bin. Inside the pipe is an auger that feeds the coal into the firepot inside the stove.

Here is newly assembled firepot for an EFM:
Note the holes inside the pot, this is where air is forced through to make the coal combust. Stokers do not rely on a natural draft. The pipe sized opening on the lower left is where the coal would enter via the auger. It feeds up from the bottom of the pot, as more coal is fed the ashes spill over the sides into ash can below. Basically all you need to do is put coal in one side and take the ashes out of the other. You can find a complete pictorial of the EFM assembly from start to finish by here:
Pictorial of all DF520 Stoker Parts and Assemblies - e-f-m Heating
Axeman-Anderson and AHS make another type based on the athratube design which was part of a study, this is the one that can achieve the highest efficiency. It was introduced after WW2 in part in an attempt to help save the anthracite industry. This too employs an auger feed.
Bureau of Mines Report 4936 Axeman-Andersen Antratube Boiler - Coal Stokers: Boilers, Furnaces and Stoves
Lastly there is the bed type, these use a hopper on the side of the furnace or the stove. They are used in both large boilers and the more common smaller hot air stokers. This is a smaller keystoker made for supplementary heat. These typically are 90KBTU though and can provide most of the heat in a 2000 sq ft. home providing you get it to circulate well, Note that there is hopper on the back you fill and the coal is fed from there:
They also make a large boiler, note the hopper on the side.
This what it looks like, the coal is pushed from the back and off the end into an ash pan:
These stokers are thermostatically controlled. They will ramp up or down depending on the demand for heat. It's no different than any other furnace except for the little bit of work. Typically during the coldest days of the winter you will need to add coal about every 2 days and take the ashes out. Overall not more than few minutes each day to keep it going.
Hand fired stoves as already mentioned are very similar to wood stoves. they use a shaker grate system. These generally need to be attended too once every 12 hours, in comparison a wood stove needs to be refueld ever 4 or 5 hours. The benefit of having a stove like this is they don't need electricity to run. If the power goes out in your area frequently this would be an ideal solution. Here's a picture of shaker grate, this is from a unit EFM will be reintroducing:
This grate sits in the bottom of a firebox, twice a day you will need to shake the coal down to get rid of the ashes and add new coal. The combustion is controlled via the draft, you can turn the heat up or down by adjusting the amount of air. These are not like stokers with on demand heat. If for example you put more air on the coal it will take up a length of time to ramp up. Turning it back down takes even longer. Most people find an appropriate setting and just leave it there and do there twice a day routine.
Ran out of room for images, see next post.