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In the Hotspot Options dialog click on the 'Add' button. You will see this dialog:
To add a new hotspot, you must specify the text that will identify the hotspot on the screen. Enter the text you want recognized as a hotspot into the 'Hotspot Text' field. Remember that this text can not contain spaces and it must be unique.
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Alternatively you can have a hotspot run a script file, a previously recorded keystroke file, or an external program. Select the appropriate button to activate this option.
You can enter the fully qualified name and path of the file (i.e. C:\Windows\Notepad.exe) or you can use the 'Browse' button to select an existing file from your file system.
After making your selections, click OK and the hotspot will be added to your hotspot list for the current session.