This functionality requires that you have SMTP (Simple Mail Transfer Protocol - the de facto standard for e-mail transmissions across the Internet) installed. You will not be able to access the Notification tab if SMTP is not installed.
If the SMTP Service is not installed you will be prompted accordingly upon opening the MedicalDirector Backup application. To install the SMTP Service refer to Installing the SMTP Service.
E-mail Notification can only be used when scheduling a backup.